中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
2期
140-143
,共4页
上斜肌减弱术%亢进%A型斜视%旋转状态
上斜肌減弱術%亢進%A型斜視%鏇轉狀態
상사기감약술%항진%A형사시%선전상태
Superior oblique weakening%Overaction%A-pattern deviation%Torsion
目的 探讨上斜肌减弱(断腱或后徙)术矫正伴上斜肌功能亢进A征的效果及眼球旋转状态的改变.方法 收集伴双侧上斜肌亢进的A型斜视82例,断腱术79例,后徙术3例,观察手术前后第一眼位、上下方斜视度及上斜肌亢进程度,于术前和术后1d行双眼眼底照相并测量黄斑-视盘夹角(FDA).结果 (1)断腱组:①术前A征斜度平均为(23.47±9.08)△;手术减少(25.27±11.79)△;随访期末残余斜度差为(-1.98±6.60)△,与术前比较差异有统计学意义.②术前平均FDA,右眼为(9.08±5.40)°、左眼为(12.10±4.77)°、双眼为(20.87±8.49)°;平均减少量,右眼(7.57±4.71)°、左眼(8.28±5.38)°、双眼(15.72±7.01)°;术后第1天FDA右眼(0.90±4.90)°、左眼(3.34±5.33)°、双眼(4.23±7.58)°;双眼FDA手术前、后比较,差异有统计学意义.(2)后徙组3例患者A征消失,手术矫正量为23△、35△、31△,双眼总FDA减少为24.00°、10.80°和11.00°.结论 双侧上斜肌减弱术可有效矫正A征和眼球内旋状态.断腱术A征矫正量与术前A征的度数呈正相关,术后内旋转度数减少量与术前客观旋转度数呈正相关.
目的 探討上斜肌減弱(斷腱或後徙)術矯正伴上斜肌功能亢進A徵的效果及眼毬鏇轉狀態的改變.方法 收集伴雙側上斜肌亢進的A型斜視82例,斷腱術79例,後徙術3例,觀察手術前後第一眼位、上下方斜視度及上斜肌亢進程度,于術前和術後1d行雙眼眼底照相併測量黃斑-視盤夾角(FDA).結果 (1)斷腱組:①術前A徵斜度平均為(23.47±9.08)△;手術減少(25.27±11.79)△;隨訪期末殘餘斜度差為(-1.98±6.60)△,與術前比較差異有統計學意義.②術前平均FDA,右眼為(9.08±5.40)°、左眼為(12.10±4.77)°、雙眼為(20.87±8.49)°;平均減少量,右眼(7.57±4.71)°、左眼(8.28±5.38)°、雙眼(15.72±7.01)°;術後第1天FDA右眼(0.90±4.90)°、左眼(3.34±5.33)°、雙眼(4.23±7.58)°;雙眼FDA手術前、後比較,差異有統計學意義.(2)後徙組3例患者A徵消失,手術矯正量為23△、35△、31△,雙眼總FDA減少為24.00°、10.80°和11.00°.結論 雙側上斜肌減弱術可有效矯正A徵和眼毬內鏇狀態.斷腱術A徵矯正量與術前A徵的度數呈正相關,術後內鏇轉度數減少量與術前客觀鏇轉度數呈正相關.
목적 탐토상사기감약(단건혹후사)술교정반상사기공능항진A정적효과급안구선전상태적개변.방법 수집반쌍측상사기항진적A형사시82례,단건술79례,후사술3례,관찰수술전후제일안위、상하방사시도급상사기항진정도,우술전화술후1d행쌍안안저조상병측량황반-시반협각(FDA).결과 (1)단건조:①술전A정사도평균위(23.47±9.08)△;수술감소(25.27±11.79)△;수방기말잔여사도차위(-1.98±6.60)△,여술전비교차이유통계학의의.②술전평균FDA,우안위(9.08±5.40)°、좌안위(12.10±4.77)°、쌍안위(20.87±8.49)°;평균감소량,우안(7.57±4.71)°、좌안(8.28±5.38)°、쌍안(15.72±7.01)°;술후제1천FDA우안(0.90±4.90)°、좌안(3.34±5.33)°、쌍안(4.23±7.58)°;쌍안FDA수술전、후비교,차이유통계학의의.(2)후사조3례환자A정소실,수술교정량위23△、35△、31△,쌍안총FDA감소위24.00°、10.80°화11.00°.결론 쌍측상사기감약술가유효교정A정화안구내선상태.단건술A정교정량여술전A정적도수정정상관,술후내선전도수감소량여술전객관선전도수정정상관.
Objective To investigate tenectomy(ST)and recession(SR),and their effects in treatment of A pattern,superior oblique overaction,and torsion.Methods Pre- and Post-operative primary eye position,upgaze and downgaze of deviation,superior oblique muscle function,fundus photograph were examined and analyzed in 82 patients of A-pattem deviation with bilateral superior oblique overaction(SOOA).Results ST ① Mean A-pattern was(23.47± 9.08)△ before and(-1.98± 6.60)△ after the operation.Mean correction was (25.27±11.79)△.② The mean pre-operative fovea-disc angle(FDA)of both eyes was(20.87± 8.49)° ,with the mean decreasing of(15.72± 7.01),and the mean FDA was(4.23± 7.58)° 1 day after operation.SR The mean correction of A pattern was 23△,35△and 31 △.The mean correction of total FDA was 24.00° ,10.80° and 11.00° .Conclusions Bilateral superior oblique weakening is effective in correcting A-pattern deviation and incyclodeviation.
