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目的斜视矫正手术有时需要在一只眼上同时离断3条或3条以上直肌,因而过多地损伤了睫状前动脉,导致眼前节缺血综合征的发生。本课题主要是探讨斜视矫正手术多条眼外肌一次完成的方法。方法本组手术均在局麻下进行,结膜下注射2%利多卡因,做肌止端结膜切口,暴露直肌,显微镜下将延直肌走行的睫状前动脉分离出来,离断肌肉时保留血管。手术量和术式与常规眼外肌手术相同。结果斜视矫正效果:治愈32例(88.89%),好转4例(11.11%)。采用彩色多普勒测定虹膜大环术前术后血流流速,差异无显著性。结论应用血管分离术可实现多条眼外肌手术一次完成。眼外肌睫状前动脉血管显微分离术最大限度地降低眼前节缺血发生的可能。减少手术次数,既简化了斜视矫治过程又减轻了病人的痛苦。
Objective Strabismus surgery sometimes requires the simultaneous disconnection of three or more rectus muscles in one eye, resulting in excessive damage to the anterior ciliary artery leading to anterior segment ischemic syndrome. The main topic of this study is to explore strabismus surgery more than one extraocular muscle to complete the method. Methods This group of operations were performed under local anesthesia, 2% lidocaine subconjunctival injection, so that the myocutaneous conjunctiva incision, expose the rectus muscle, under the microscope the ciliary muscle before walking the ciliary anterior artery separation, Keep blood vessels. Surgery and surgical procedures and the same routine eye muscle surgery. Results Strabismus correction effect: cured 32 cases (88.89%), improved in 4 cases (11.11%). Color Doppler was used to measure the preoperative and postoperative iris macrophage flow velocity, the difference was not significant. Conclusion The application of vascular separation surgery can achieve a number of extraocular muscle surgery completed. Extraocular muscle ciliary anterior artery vascular microdissection to minimize the possibility of anterior segment ischemia. Reduce the number of operations, both to simplify the process of strabismus and reduce the patient’s pain.