直肌内血管显微分离术方法的实验研究

目的探讨眼直肌内睫状前动脉(ACAs)显微分离术的方法和技巧及应用此方法在一眼同时行4条直肌手术的安全可行性.方法对健康成年杂种犬10只16只眼行直肌内睫状前血管显微分离术.其中8只眼行直肌联结术(Jensen术式),8只眼行肌肉转位术(Hummelsheim术式),术后观察眼前段反应三个月.结果垂直肌的血管较水平肌粗,易分离.ACAs在直肌内的数目存在变异.每例手术均成功分离并保留了大多数ACAs,两种术式术后均未发现眼前节缺血(ASI).结论直肌内血管显微分离术是一种安全可行的显微手术方法,可使累及多条直肌的复杂斜视手术一次完成,避免或减少了ASI的风险.

A method for vascular microdissection in the rectus muscles of the dog'seye

Objective:To investigate a method for vascular microdissection of the anterior ciliary arteries(ACAs) in the rectus muscles,and to evaluate the safety of this technique when surgery is performed simultaneously on all 4 recti in one eye.Methods:The anterior ciliary vessels were dissected under a surgical microscope in 16 eyes of 10 normal adult dogs. All eyes underwent surgery on 4 recti simultaneously. The Jensen procedure was performed on 8 eyes and the Hummelsheim procedure was performed on the other 8 eyes. Changes in the anterior segment of the eye were observed for 3 months postoperatively to determine the effects on the anterior segment.Results:The cavity of ACAs in the vertical recti was larger and easier to dissect than those in the horizontal recti. Most of the ACAs in each eye were dissected and preserved. In some cases,there was a variation in the number of ACAs,where 3 or 4 branches were found instead of 2. None of the 16 eyes showed signs of anterior segment ischemia(ASI) postoperatively.Conclusion:This study showed that microdissection of muscular vessels is a safe and practical ophthalmic microsurgery technique. It is therefore possible that sections of 3 or 4 recti can be corrected simultaneously in cases of complex strabismus. This method might avoid the risk of postoperative ASI. FK(WB80011?6]