目的:探讨高频超声引导下注射A型肉毒杆菌毒素(botulinum toxin A,BTXA)治疗甲状腺相关眼病(thyroid associated ophthalmopathy,TAO)限制性斜视的临床效果。方法:选择32例TAO限制性斜视患者,在眼科高频超声引导下注射BTXA。观察注射前后的斜视度及复视的变化情况。结果:患者32例经重复注射2～4次BTXA后,其斜视度及复视情况有不同程度的减轻。总体显效率占47%,有效率占44%,无效率占9%。结论:高频超声引导下注射BTXA治疗TAO限制性斜视,定位准确,是一种有效缓解眼外肌痉挛和减轻复视症状及斜视度的方法。

AIM:To observe the clinical effects of botulinum toxin A(BTXA) injection guided by high-frequency ultrasound in the treatment of restrictive strabismus in thyroid associated ophthalmopathy.METHODS: Thirty-two patients with restrictive strabismus in thyroid associated ophthalmopathy were recruited in clinical study.Under the guide of high-frequency B ultrasound diagnostic apparatus, BTXA was injected into the extra-ocular muscles.The changes of the degree of and strabismus diplopia were observed after therapy.RESULTS: In all eyes of 32 patients,the strabismus and diplopia were lessened in different degrees after repeated injection with botulinum toxin A in the affected extra-ocular muscles for 2 to 4 times. The total apparent rate was 47%,effective rate was 44%, ineffective rate was 9%.CONCLUSION: BTXA injection guided by high-frequency ultrasound technique is accurate positioning method in the treatment of restrictive strabismus in thyroid associated ophthalmopathy. It is an effective therapy to lighten the contraction of extra-ocular muscles remission of diplopia symptom and strabismus degree.

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