【摘要】 目的：探讨水平直肌斜视矫正术对患者散光的影响。方法： 选取30名水平斜视患者进行前瞻性研究，对所有患者术前和术后第1d均进行三棱镜交替遮盖试验、视力和屈光检查，根据三棱镜度进行不同的手术矫正。将术前和术后测定的散光值转变为Cartesian坐标系下的数值，然后再对术前和术后第1d的散光变化进行统计学分析。结果：共有30名患者50眼参与本次研究，所有接受水平直肌斜视矫正术的患者术后第1d较术前散光无显著性变化。结论：水平直肌斜视矫正术对患者散光无显著影响，长期效果需进一步观察。
【关键词】 散光；水平直肌斜视矫正术；三棱镜
Effect of horizontal rectus strabismus correction surgery on the astigmatism
YaLin Ren, Chao Jing
1 Sun Yatsen University, Guangzhou 510060, Guangdong Province, China; 2 Department of Ophthalmology, Zhongshan Peoples Hospital, Zhongshan 528403, Guangdong Province, China; 3 Department of Ophthalmology,Shengjie Hospital, Zibo 256400, Shandong Province, China
Correspondence to:YaLin Ren. Department of Ophthalmology, Zhongshan Peoples Hospital, Zhongshan 528403, Guangdong Province, China. [email protected]
AbstractAIM: To evaluate the effect of horizontal rectus strabismus correction surgery on the astigmatism.
METHODS: Thirty patients with horizontal strabismus were included in this prospective study. The patients ocular alignment through the prism cover test, visual acuity and autorefraction was performed by a technician. The surgery correction was done according to the prism cover test and the surgery was finished by the same ophthalmologist. The differences of astigmatism between the preoperative and first postoperative day were calculated and we converted the data from the usual method of describing astigmatism in polar coordinates (cylinder and axis) to a Cartesian coordinate system. Descriptive statistics were used to analyze the data.RESULTS: A total of 30 patients (50 eyes) were enrolled in the present study. For all patients who underwent horizontal rectus straismus correction surgery, There was no significant change in astigmatism between preoperative result and the first day after operation result.CONCLUSION: Thehorizontal rectus strabismus correction surgery has no remarkable effect on patients astigmatism. The longterm effects need to be observed in future.
KEYWORDS: astigmatism; horizontal strabismus surgery; prism
引言
斜视是一种常见眼病，斜视矫正术中最常见的是水平直肌的矫正。过去有文献报道[18]，水平直肌的斜视矫正术可以通过眼外肌对巩膜受力的改变从而引起角膜散光的改变。本文主要通过对斜视患者水平肌矫正术前、术后屈光的改变进行研究，进一步探讨水平肌斜视矫正术对散光的影响。
1对象和方法
1.1对象
收集30个共同性斜视患者作为本次研究对象，所有患者均排除角膜疾病、既往眼部手术史和其他眼部疾病。
1.2方法
对所有患者术前进行三棱镜交替遮盖试验、视力和屈光度检查，斜视矫正术为单侧或双侧直肌后徙或截除术，手术量根据三棱镜交替遮盖试验确定，所有手术均由同一个医生完成；并在术后第1d对所有患者再次进行眼位、视力和屈光度检查。屈光度检查所用仪器为日本产电脑验光仪（Topcon，KR8100）,并由同一个验光师进行检测。本次研究主要统计患者手术前后散光度和散光轴的变化，将手术前后散光表示为+散光度×散光轴，根据Cartesian坐标系计算手术对散光影响的方法，简言之就是将传统表示散光的带有方向数值，根据Holladay等[7]提出的公式，转变为Cartesian坐标系下无方向性的数值求均值、标准差或进行统计学比较。
统计学处理：应用SPSS 11.0统计软件配对t检验进行分析，以P<0.05为统计学显著性差异判定标准。
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