张硕, 李寅炜, 宋雪霏, 孙静, 周慧芳, 范先群. 深外侧壁眼眶减压术治疗甲状腺相关眼病的疗效观察[J]. 蚌埠医学院学报, 2018, 43(10): 1359-1363. DOI: 10.13898/j.cnki.issn.1000-2200.2018.10.021
    引用本文: 张硕, 李寅炜, 宋雪霏, 孙静, 周慧芳, 范先群. 深外侧壁眼眶减压术治疗甲状腺相关眼病的疗效观察[J]. 蚌埠医学院学报, 2018, 43(10): 1359-1363. DOI: 10.13898/j.cnki.issn.1000-2200.2018.10.021
    ZHANG Shuo, LI Yin-wei, SONG Xue-fei, SUN Jing, ZHOU Hui-fang, FAN Xian-qun. Effect of deep lateral wall orbital decompression in the treatment of thyroid-associated ophthalmopathy[J]. Journal of Bengbu Medical College, 2018, 43(10): 1359-1363. DOI: 10.13898/j.cnki.issn.1000-2200.2018.10.021
    Citation: ZHANG Shuo, LI Yin-wei, SONG Xue-fei, SUN Jing, ZHOU Hui-fang, FAN Xian-qun. Effect of deep lateral wall orbital decompression in the treatment of thyroid-associated ophthalmopathy[J]. Journal of Bengbu Medical College, 2018, 43(10): 1359-1363. DOI: 10.13898/j.cnki.issn.1000-2200.2018.10.021

    深外侧壁眼眶减压术治疗甲状腺相关眼病的疗效观察

    Effect of deep lateral wall orbital decompression in the treatment of thyroid-associated ophthalmopathy

    • 摘要: 目的:观察深外侧壁眼眶减压术治疗甲状腺相关眼病的效果及安全性。方法:选择2016年1月至2018年1月行深外侧眼眶减压术治疗的甲状腺相关眼病病人作为研究对象。比较病人术前和术后3个月的眼球突眼度,最佳矫正视力,眼压,上、下睑缘至角膜映光点的距离,复视情况和眼球运动受限情况。结果:共纳入23例(35眼)病人,其中男9例(12眼),女14例(23眼),平均年龄(41.5±14.4)岁。深外侧壁减压可使术后眼球回退(3.7±0.9)mm,差异有统计学意义(P<0.01)。2眼伴压迫性视神经病变的病人中,术后最佳矫正视力均有明显提高。术后眼压平均下降(1.9±1.6)mmHg,上睑和下睑退缩平均改善1.0 mm,差异有统计学意义(P<0.01)。术后2例病人原有复视加重,3例病人复视缓解,6眼眼球运动障碍缓解,无眼球运动障碍加重。结论:深外侧壁眼眶减压术可有效扩大眼眶容积,眼球明显回退的同时术后复视发生率低,视力恢复佳,并改善上睑和下睑退缩,眶内损伤小,并发症少。

       

      Abstract: Objective:To evaluate the effects and safety of deep lateral orbital decompression in the treatment of thyroid-associated ophthalmopathy(TAO).Methods:The clinical data of patients with TAO treated with deep lateral orbital decompression from January 2016 to January 2018 were collected.The proptosis,best corrected visual acuity(BCVA),intraocular pressure(IOP),distance of upper and lower lid margin from reflex(MRD-1 and MRD-2,respectively),diplopia and ocular restriction between before operation and after 3 months of operation were compared.Results:The mean age of 23 patients with thirty-five orbits9 male(12 orbits),14 female(23 orbits) was(41.5±14.4)years.The average proptosis reduction was(3.7±0.9)mm(P<0.01).The mean IOP reduction was(1.9±1.6)mmHg(P<0.01).The median improvement in upper and lower eyelid retraction were 1.0 mm(P<0.01).After operation,the diplopia in two cases worsened,the diplopia in 3 cases relieved,the ocular dyscinesia in 6 cases relieved,and no aggravation was found.Conclusions:Deep lateral wall orbital decompression can effectively expand orbital volume,and improve eyelid retraction.The eye clearly recedes,the incidence rate of postoperative diplopia is low,the visual recovery is good,and the intra-orbital injury is little.

       

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