目的：利用计算机辅助的角膜地形图分析眼外肌手术前后眼角膜表面的屈折力及其轴位的变化情况．方法：选取眼外肌手术患者２８例（４５只眼），其中水平直肌手术１７例（３４只眼），垂直斜肌手术１１例（１１只眼），由同一专职技师，于术前１天和手术后１个月，作角膜地形图检查，并运用计算机进行分析处理．结果：水平斜视采用内（外）直肌徙后的术式，垂直斜视采用下斜肌断腱术，分别比较两种不同手术前后角膜表面屈光度和轴位的变化．经ｔ检验，ｐ＞０．０５，表明两者均无显著性差异．讨论：角膜的形态受水肿、创伤、疤痕等诸多因素的影响，角膜曲度的变化与眼外肌的牵拉或压迫眼球有关．眼外肌术后短期内由于肌肉紧张度的改变，球结膜水肿，巩膜或结膜疤痕的影响，角膜水平，垂直径线上的屈光力会发生改变．但从远期观察，手术前后角膜表面各点屈折力的差异无显著性改变．结论：本文２８例患者的角膜地形图形态均为纵向的，对称或不对称的蝴蝶结形，眼外肌手术后眼角膜最大屈光力的轴向仍落在角膜垂直向范围，与术前相比较无显著性差异． OBJECTIVE: To analyze the refractive power and axial changes of corneal surface before and after operation with computer-assisted corneal topography. Methods: Twenty-eight patients (45 eyes) underwent extraocular muscle surgery were selected, including 17 cases of horizontal rectus muscle operation (34 eyes) and 11 cases of vertical oblique muscle operation (11 eyes) Day and 1 month after surgery, corneal topography examination, and the use of computer analysis and processing. Results: Horizontal strabismus was treated by internal (external) rectus femoris migration and vertical strabismus was performed by inferior oblique transection tendon surgery. The corneal surface diopters and axial changes were compared before and after surgery. After t test, p> 0.05, indicating no significant difference between the two. Discussion: corneal morphology by edema, trauma, scar and many other factors, changes in corneal curvature and extraocular muscle stretch or oppression of the eye. Short-term extraocular muscle surgery due to changes in muscle tone, conjunctival edema, sclera or conjunctival scarring, corneal horizontal, vertical diameter of the refractive power will change. However, from the long-term observation, there was no significant difference in the refractive power of the corneal surface before and after surgery. CONCLUSIONS: All 28 corneal topographies showed longitudinal, symmetrical or asymmetrical bowknot shape. The maximum axial corneal power of ocular muscles remained unchanged in the cornea vertical range after surgery, compared with preoperative Significant difference.