中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
12期
1309-1312
,共4页
韩惠芳%孙卫锋%刘素江%韩爱军
韓惠芳%孫衛鋒%劉素江%韓愛軍
한혜방%손위봉%류소강%한애군
A型斜视%上斜肌减弱手术%上斜肌功能
A型斜視%上斜肌減弱手術%上斜肌功能
A형사시%상사기감약수술%상사기공능
A- pattern strabismus%superior oblique surgery%Superior oblique function
目的 探讨上斜肌减弱手术对A型斜视和上斜肌功能的影响.方法 对23例双眼上斜肌功能亢进伴A型斜视患者分别施行双眼上斜肌断腱术和肌腱延长术；对术前术后A征的矫正情况、上斜肌的功能状况和双眼视功能等方面进行对比研究.结果 23例,术前A征平均(22.14±12.94)△,术后上方与下方水平斜视度之差平均(5.11±7.10)△；A征矫正量:肌腱延长术( 22.64±7.46)△,断腱术(31.69±12.63)△,二者比较差异有统计学意义(P＜0.05).上斜肌功能眼位垂直斜视矫正量:延长术( 11.04±3.61)°,断腱术( 14.95±3.77)°,二者比较差异有统计学意义(P＜0.05),上斜肌断腱术对A征和上斜肌功能的减弱作用均较肌腱延长术明显,术后上斜肌功能不足和V型斜视的发生率明显高于肌腱延长术；肌腱延长术后双眼视觉的恢复好于上斜肌断腱术.结论 两种上斜肌减弱手术对伴上斜肌亢进的A型斜视均有效；上斜肌延长术对于轻中度上斜肌亢进和A型斜视治疗效果好于断腱术；有双眼单视功能的患者施行延长术比较安全.
目的 探討上斜肌減弱手術對A型斜視和上斜肌功能的影響.方法 對23例雙眼上斜肌功能亢進伴A型斜視患者分彆施行雙眼上斜肌斷腱術和肌腱延長術；對術前術後A徵的矯正情況、上斜肌的功能狀況和雙眼視功能等方麵進行對比研究.結果 23例,術前A徵平均(22.14±12.94)△,術後上方與下方水平斜視度之差平均(5.11±7.10)△；A徵矯正量:肌腱延長術( 22.64±7.46)△,斷腱術(31.69±12.63)△,二者比較差異有統計學意義(P＜0.05).上斜肌功能眼位垂直斜視矯正量:延長術( 11.04±3.61)°,斷腱術( 14.95±3.77)°,二者比較差異有統計學意義(P＜0.05),上斜肌斷腱術對A徵和上斜肌功能的減弱作用均較肌腱延長術明顯,術後上斜肌功能不足和V型斜視的髮生率明顯高于肌腱延長術；肌腱延長術後雙眼視覺的恢複好于上斜肌斷腱術.結論 兩種上斜肌減弱手術對伴上斜肌亢進的A型斜視均有效；上斜肌延長術對于輕中度上斜肌亢進和A型斜視治療效果好于斷腱術；有雙眼單視功能的患者施行延長術比較安全.
목적 탐토상사기감약수술대A형사시화상사기공능적영향.방법 대23례쌍안상사기공능항진반A형사시환자분별시행쌍안상사기단건술화기건연장술；대술전술후A정적교정정황、상사기적공능상황화쌍안시공능등방면진행대비연구.결과 23례,술전A정평균(22.14±12.94)△,술후상방여하방수평사시도지차평균(5.11±7.10)△；A정교정량:기건연장술( 22.64±7.46)△,단건술(31.69±12.63)△,이자비교차이유통계학의의(P＜0.05).상사기공능안위수직사시교정량:연장술( 11.04±3.61)°,단건술( 14.95±3.77)°,이자비교차이유통계학의의(P＜0.05),상사기단건술대A정화상사기공능적감약작용균교기건연장술명현,술후상사기공능불족화V형사시적발생솔명현고우기건연장술；기건연장술후쌍안시각적회복호우상사기단건술.결론 량충상사기감약수술대반상사기항진적A형사시균유효；상사기연장술대우경중도상사기항진화A형사시치료효과호우단건술；유쌍안단시공능적환자시행연장술비교안전.
Objective To evaluate the efficacy of tenectomy and tendon-expander of the superior oblique tendon to superior oblique muscle function and A- pattern strabismus.Methods A total of 23patients with the superior oblique overaction and A-pattern strabismus were treated with the superior oblique tendon-expander technique and superior oblique tenotomy or tenectomy.Pre- and post-operative eye positions,A-Pattern Strabismus,function of superior oblique and binocular visual function were examined and analyzed.Results Twenty-three cases,pre-operative A-Pattern averaged (22.14± 12.94)△.The difference in deviation between up and downgaze average was (5.11± 7.10)△ in post-operative.Apattern strabismus degrees (22.64± 7.46)△ was corrected in superior oblique tendon-expander and (31.69± 12.63)△ in tenotomy.There were significant differences (P ＜0.05).The vertical deviation in function position of superior oblique muscle average was corrected (11.04± 3.61)° in tendon-expander and (14.95± 3.77)° in tenotomy.There were significant differences (P ＜0.05); oblique muscle palsy and postoperative V pattern strabismus were significantly higher in tenectomy than the tendon lengthening of the superior oblique tendon.For the recovery of binocular visual function.Superior oblique lengthening was better than tenectomy.Conclusions Two kinds of superior oblique weakening surgery are effective approach to A-pattern strabismus with the superior oblique overaction treatment.For the treatment of mild-to-moderate superior oblique overaction and A-strabismus,superior oblique tendon-expander technique is better than teneetomy.Superior oblique lengthening is safer for patients with good binocular visual function.
