儿童垂直斜视术后角膜散光的分析

目的 探讨儿童垂直斜视矫正术后角膜散光状态的变化以及其与时间的关系.方法 对垂直斜视36例（58眼）采用术前术后阿托品散瞳验光及角膜地形图检查,术后不同时期的散光度进行比较分析,寻找规律.结果 Ⅰ组（上直肌后徙加下斜肌减弱）和Ⅱ组（上直肌后徙加下直肌缩短合并下斜肌部分切除）术后均有不同程度的角膜散光度改变,Ⅱ组较Ⅰ组明显,与术前相比差异均有统计学意义.结论 不同手术方式术后角膜散光度的恢复时间不同,垂直肌后徙加缩短恢复较慢,甚至术后8周有部分患儿仍不能完全恢复,因此配镜矫正时间应根据角膜散光的恢复情况而定.

Changes of corneal astigmatism after vertical strabismus surgery in children

Objective To study the changes of corneal astigmatism and variation with time after vertical strabismus correction surgery in children. Methods Fifty-eight eyes of 36 cases with vertical strabismus were examined by atropine mydriasis optometry and corneal topography before and after surgery. The astigmastism at different time points were compared and analyzed. Results The patients were divided into two groups based on the different surgical methods. The group I was treated by upper rectus recession combined with inferior oblique weakening and the group Ⅱ underwent upper rectus recession and inferior rectus shortening combined with partial excision of the inferior oblique muscle. Compared with the preoperative values, the corneal astigmatism increased significantly in two groups. The increase of group II was more than that of group I. Conclusion The recovery time of corneal astigmatism is different because of different operations. The vertical muscle shortening procedure has longer recovery time than other operations. Even 8 weeks after surgery, some children are still not fully recovered. Therefore optimal time of refractive correction with glasses should be decided based on the specific recovery condition of the cornea.