实验性眼直肌内血管显微分离及眼前段病理学观察

目的探讨一眼同时行4条直肌手术时采用直肌内血管显微分离术对眼前段的影响。方法16只犬眼,8只行直肌联结术,8只行直肌转位术,术中对睫状前动脉(ACAs) 行显微分离术予以保留,术后观察眼前段3个月,对虹膜睫状体行组织学和超微结构观察。结果大多数ACAs成功分离并保留,发现垂直肌的血管较水平肌粗,易分离。术后未发现眼前段缺血(ASI)。光、电镜观察组织细胞无缺血改变。结论将血管显微分离术应用于斜视手术中,可使累及三条以上直肌的手术一次完成,避免了ASI的风险。手术中应重点保护垂直肌的ACAs。

Pathological observation of the anterior eye segment following isolation of the vessels in therectus by microdissection

Objective To investigate the impact of simultaneously isolating the vessels in 4 recti of one eye by means of microdissection on the anterior segment. Methods Among the 16 dogs, 8 received coupling of the recti (with Jensen procedure) and the others received rectus displacement (with Hummelsheim procedure). Microdissection of the anterior ciliary arteries (ACAs) were performed and 3 months later, the anteror segment tissues were observed with both light and electron microscopes. Results Most of the ACAs were successfully isolated and preserved which were thicker in the vertical recti than in the horizontal recti. No signs of anterior segment ischemia (ASI) were observed in the 16 eyes with the operation postoperatively. Conclusion Vascular microdissection in strabismus surgery that involves 3 or 4 recti might avoid the risk of ASI, during which the ACAs of the vertical rectus should be carefully preserved.