共同性斜视手术与lasik先后问题的探讨.docVIP

共同性斜视手术与LASIK先后问题的探讨 ［摘要］nbsp; 目的nbsp; 研究共同性斜视手术与LASIK先后对手术效果的影响。方法nbsp; 选择矫正视力≥1.0，合并有共同性斜视与近视的患者。两手术间隔6个月。完成两手术后观察病人的眼位、视力、双眼视功能、结膜切口、角膜瓣情况等并进行分析。结果nbsp; 术后眼位正位（≤10△）率、双眼视力≥1.0比例、建立双眼视功能比例、结膜切口痊愈率、角膜瓣痊愈率差异均无显著性。结论nbsp; 无论先做斜视还是先做近视，术后效果差异无显著性。笔者观察只要术前测量准确斜视角度、近视度数，术中注意保护角膜、结膜，观察好眼位，即可减少并发症的发生。 　［关键词］nbsp; 斜视；近视 nbsp;nbsp;nbsp;nbsp; Outcome of different sequence of comitant operation and LASIK nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; ［Abstract］nbsp; Objectivenbsp; To study the influence of first comitant strabismus operation or LASIK on the surgical operation outcome.Methodsnbsp; Chosen the patients with comitant strabismus and myopia,their corrects vision ≥1.0.Two surgical operation partition half a years.Observed and analyzed their eye position,vision,binocular single vision function,conjunctiva cut,the cornea petal circumstance.etc after operation.Resultsnbsp; Rate of orthophoria after operation,both eye vision ≥1.0,establishment binocular single vision function,conjunctiva cut completely recovered,cornea petal completely recovered have no significance difference.Conclusionnbsp; Result have no significance difference whether strabismus operation first or LASIK.As long as accurate measured the angle of strabismus,degrees of myopia before operation;pay attention to protecting cornea,conjunctiva in the surgical operation,observing careful eye position,then we can reducing the occurrence of the complications based on observation. nbsp;nbsp;nbsp; ［Key words］nbsp; strabismus；myopia nbsp;nbsp;nbsp; 随着近视与斜视手术的广泛开展,为探讨手术先后问题对术后效果有无影响，现将我院收治的57例患者的临床资料总结分析如下。 nbsp;nbsp;nbsp; 1nbsp; 资料与方法 nbsp;nbsp;nbsp; 1.1nbsp; 一般资料nbsp; 2003年8月～2005年8月我院共收治共同性斜视合并近视病人57例，双眼矫正视力≥1.0，眼部没有其他器质性病变。年龄18～37岁，中位数24岁。分两组：A组先做近视，23例，B组先做斜视，34例。两手术间隔6个月。 nbsp;nbsp;nbsp; 1.2nbsp; 方法nbsp; 近视患者做LASIK，用Moria刀做瓣，角膜瓣的蒂均位于上方。术后点人工泪液、抗生素、皮质类固醇激素眼药。斜视患者做水平直肌的徙后和（或）缩短，均做肌止端结膜切口，术后局部/全身抗炎，同视机训练，1周拆线。术后均定期复查。术后检查以3～6个月为准，纪录眼位、视力、双眼视功能、结膜切口、角膜瓣情况。双眼视功能达到有同时视功能、融合功能、远立