眶壁骨折修复术后斜视和复视的手术治疗

目的 观察眶壁修复术后斜视和复视眼外肌手术矫正效果.方法 对14例眼眶爆裂性骨折修复手术6月后仍有斜视和复视的患者,采取二期眼外肌手术治疗.结果 4例为限制性斜视,二期手术探查,松解肌肉、解除限制因素,后徙受累肌或/和缩短拮抗肌后,前方及前下方视野内复视消除;10例为非限制性眼肌功能不足所致斜视,二期手术缩短受累肌/和后徙拮抗肌后,9例复视明显好转,前方及前下方视野内垂直及水平斜视度分别小于10△和15△.1例仍有眼位偏斜,需佩戴三棱镜矫正复视.结论 正确分析爆裂性眼眶骨折修复术后斜视和复视的原因,采取相应的术式,可获得较好的治疗效果.

The surgical treatment of strabismus and diplopia after repair of orbital fracture

Objective To observe the effective of surgical treatment of strabismus and diplopia after repair of orbital fracture.Method 14 patients with strabismus and diplopia who had accepted surgical repair of orbital fracture bypass 6 months were offered strabismus surgery.Result 4 patients with restrictive strabismus were removed the frontal and downward diplopia by secondary ocular muscle surgery to release the restricted extraocular muscles,recess the restricted muscle and/or resect the antagonistic muscle;among the 10 patients with non-restrictive strabismus, 9 patients' diplopia amended obviously, the vertical and horizontal degree of strabismus in frontal and downward visual field were less than 10△ and 15△ by surgery to recess the antagonistic muscle and/or resect the restricted muscle.One patient with residual squint need wear prism to abate diplopia.Conelusion To analysis the reasons of strabismus and diplopia after repair of orbital fracture rightly and choice proper surgery methods, the better effect can be gained.