白内障术后垂直斜视的治疗观察

• 作 者: 罗肇文 孙志河 苏静
• 机 构: 大连医科大学附属第一医院眼科,大连医科大学附属第一医院眼科,大连医科大学附属第四医院眼科 116011,116011
• 出 处: 中国斜视与小儿眼科杂志
• 发表日期: 2004年02期
• 关键词: 白内障 斜视 治疗

目的探讨白内障摘除人工晶体植入术后垂直斜视的原因、表现和治疗方法。方法对9例白内障摘除人工晶体植入术后出现垂直斜视的患者进行角膜映光、眼球运动、三棱镜加Maddox杆、同视机、Hess屏及牵拉试验检查。并采用神经营养,地塞米松肌腹旁注射及手术治疗。结果9例患者中3例表现为上直肌受累,6例为下直肌受累;其中左眼受累7例,右眼受累2例;上直肌受累表现为肌肉不全麻痹,下直肌受累3例表现为肌肉亢进,3例表现为肌肉不全麻痹。7例经非手术治疗治愈,2例经手术治疗治愈。结论白内障术后垂直斜视的病人多数经非手术治疗可治愈,地塞米松肌腹旁注射对这种病人有一定价值。

Objective To investigate the causes, manifestations and treatment of vertical strabismus after cataract extraction and intraocular lens implantation. Methods Nine patients with vertical strabismus after cataract extraction and intraocular lens implantation were examined with corneal mapping, eye movements, prism with Maddox rod, synoptophore, Hess screen and traction test. And the use of neurotrophic, dexamethasone abdominal paraabdominal injection and surgical treatment. Results Three of the nine patients showed upper rectus involvement and six lower rectus muscles involved. Among them, seven patients had left eye involvement and two patients had right eye involvement. The upper rectus muscle showed paralysis of muscular dysfunction and lower rectus muscle involvement. Cases showed hyperthyroidism, 3 cases showed muscular dysfunction paralysis. Seven cases were cured by non-surgical treatment, two cases were cured by surgery. Conclusion Most patients with vertical strabismus after cataract surgery can be cured by non-surgical treatment. Dexamethasone abdominal muscles injection has some value in this kind of patients.