【摘要】 目的 探讨眼眶爆裂性骨折复视的手术治疗。方法 对外伤后出现复视及眼球内陷患者进行CT扫描，观察眼眶壁骨折及眼外肌受累程度，Hertel突眼计测量眼球内陷度数，同视机及三棱镜等眼肌学检查分析复视情况，采用前路经结膜或经睫毛下皮肤切口入路分离松解嵌顿及粘连的眼外肌，并用多孔聚乙烯眶内植入修复眶壁缺损，矫正眼球内陷。去除限制因素3个月后，用同视机及三棱镜分析复视及眼球运动情况，残余斜视采用眼肌手术或三棱镜矫正。结果 95例眼眶爆裂性骨折复视患者经眶壁骨折修复术治疗后，术后第一眼位无复视者84例(88.4%)，第一眼位有复视者11例(11.6%)。因第一眼位和功能眼位复视要求治疗者共14例(14.7%)，其中行眼外肌手术者6例，配三棱镜矫正8例。结论 眼眶爆裂性骨折所致的复视大部分可经过眼眶爆裂性骨折修复术得以矫正，少数下直肌或内直肌受损较严重者方需二次眼外肌手术或三棱镜矫正。

    【关键词】 爆裂性骨折；复视；手术治疗

    Surgical treatment of diplopia caused by blow-out fracture

    ZHAO Hong,SUN Feng-yuan,LI Qing-ji,et al.

    Department of Eye Tumor and Orbit, Tianjin Eye Hospital,Tianjin 300020,China

    【Abstract】 Objective To evaluate the effect of surgical treatment on diplopia caused by blow-out fractures.Methods Reviewed and summarized 95 cases of blow-out fracture treated by surgery, which was taken CT scan to determine the degree of the fractures and extraocular muscle injuries. Analyzed the diplopia by extraocular muscle examination. Surgery was directed at freeing the adhesion or entrapment muscles and reconstituting the orbital shape and volume. 3 months after operation ......