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目的 :应用OrbitTM1 8计算机模拟系统构建非共同性斜视的生物力学模型并预测手术矫正效果 ,探讨不同类型斜视的模拟方法以及OrbitTM1 8在斜视诊断和治疗中的应用价值。方法 :收集 15例先天性上斜肌不全麻痹、 1例外伤性内直肌断裂、 1例外展神经不全麻痹、 1例Brown综合征 ,手术前后均进行Hess屏及其它斜视相关检查 ,应用美国MillerJM等开发的OrbitTM1 8眼外肌生物力学模拟系统 ,分析眼外肌的原发和继发改变 ,通过调整相应的生物力学参数 ,建立与临床特征相符的斜视模型 ,据此验证病因推断和假设 ,并对手术方案进行模拟 ,预测术后矫正效果。结果 :构建了全部 18例非共同性斜视的术前生物力学模型 ;17例手术患者的预测矫正效果与手术后检查结果基本吻合。结论 :OrbitTM1 8生物力学模型可以对斜视的病因推断和假设进行测试 ,并预测手术矫正的效果 ,具有辅助诊断和指导手术设计的应用价值。
OBJECTIVE: To establish biomechanical models of non-common strabismus with OrbitTM1 8 computer simulation system and predict the effect of surgical correction. To explore the simulation methods of different types of strabismus and the application value of OrbitTM1 8 in the diagnosis and treatment of strabismus. Methods: Fifteen cases of congenital upper oblique dyspepsia paralysis, one case of traumatic rectus abdominis rupture, one case of abducens nerve paralysis and one case of Brown’s syndrome were collected. Hess and other strabismus examinations were performed before and after surgery. The American Miller JM And other developed OrbitTM1 8 external muscle biomechanical simulation system to analyze the primary and secondary changes in extraocular muscle by adjusting the corresponding biomechanical parameters to establish a strabismus model consistent with clinical features, based on which to verify the etiology and assumptions, And the surgical plan to simulate the prognosis of postoperative correction. Results: All preoperative biomechanical models of 18 cases of non-common strabismus were constructed. The predictive and corrective effects of 17 cases were consistent with the results of postoperative examination. CONCLUSION: The OrbitTM1 8 biomechanical model can test the etiology and hypothesis of strabismus and predict the effect of surgical correction. It has the value of assisting in diagnosis and guiding the surgical design.