斜视手术后眼血液动力学的改变

目的 :评价斜视手术后眼血液动力学的变化。方法 :对 36例斜视患者 5 6只眼行水平直肌后徙和 /或截除手术。其中 2 8只眼行一条水平直肌手术 ,2 8只眼行两条水平直肌手术。采用彩色超声多普勒显像仪分别在术前、术后一周检测术眼的睫状动脉、视网膜中央动脉的收缩期最大血流速度 (MSV)、舒张期最小血流速度 (EDV)、搏动指数 (PI)、阻力指数 (RI)。统计分析研究术前术后的血液动力学的变化。结果 :斜视手术前与术后一周睫状动脉的MSV无明显改变 (P >0 0 5 ) ,EDV、PI、RI则有显著性差异 (P <0 0 5 ) ;视网膜中央动脉的MSV、EDV、PI、RI均无明显改变 (P >0 0 5 )。另外比较行水平直肌手术一条与两条的睫状动脉、视网膜中央动脉的各血流参数均无明显差异 (P >0 0 5 )。结论 :在两条水平直肌斜视手术术后 ,睫状动脉血液动力学发生明显改变 ;而对视网膜中央动脉的血流无明显影响。认为彩色超声多普勒显像仪可以作为一种有利的工具 ,即对在涉及眼前节手术之后可能导致的眼前节缺血进行血液动力学改变的预测。

Evaluation of hemodynamic changes after strabismus surgery

Objective:To investigate the changes in blood flow after strabismus surgery by using color Doppler imaging(CDI).Methods:Of the 36 squint patients 56 eyes were underwent recession or resection surgery on the horizontal rectus muscles in 1 eye.28 eyes underwent surgery on a single horizontal rectus muscle and 28 eyes on both horizontal muscles.All patients had no systemic or ocular disorders.CDI of the central retinal artery and the ciliary artery were performed preoperatively and 1 week postoperatively.Statistical comparison of the preoperative and postoperative data was performed with T test.Results:The preoperative diastolic blood flow velocity (EDV),pulsatility index (PI) and resistivity index (RI) were different significantly from those ones at 1w postoperatively in the ciliary artery when both horizontal rectus muscles were operated ( P <0 05).No significant difference was observed between preoperative and postoperative hemodynamic parameters in the central retinal artery ( P >0 05). Conclusion:Surgery on both horizontal rectus muscles in one eye can cause hemodynamic changes in the ciliary artery.Color Doppler imaging is an useful tool in the investigation of hemodynamic alteration after interventions on anterior ocular segment that may cause ischemia in anterior ocular segment.