中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2010年
9期
1031-1033
,共3页
石荣先%方亚非%张建华%李彬
石榮先%方亞非%張建華%李彬
석영선%방아비%장건화%리빈
下斜肌功能亢进%肌部分切除术%前转位术%疗效
下斜肌功能亢進%肌部分切除術%前轉位術%療效
하사기공능항진%기부분절제술%전전위술%료효
Inferiol oblique-hypertension%Myectomy%Anterior displacement surgery%Efficacy
目的 评价下斜肌截除及前转位术治疗大度数垂直斜视的疗效.方法 以2001年1月至2009年6月收治的53例大度数垂直斜视(≥15△)患者为研究对象,均采取下斜肌截除(3～8mm)及前转位术,即转位于下直肌颞侧缘前1 mm处.对于垂直斜度在15△～25△之间者,下斜肌截除3～5mm;垂直斜度在25△以上者,下斜肌截除6mm及前转位后,术中照影观察,将残留的垂直斜度按1∶1.5的原则分配在该眼的上直肌与另一眼的下直肌(上、下直肌后徙1mm可解决1.5°的垂直偏斜);对于垂直斜度在60△以上的先天性下直肌缺如合并小角膜患者,下斜肌截除6～8mm及前转位术.伴有水平斜视时,按水平斜视矫正原则进行一并矫正.结果 经3～36mo随访,平均18mo.53例大度数垂直斜视患者Ⅰ期治愈40例(75.5%),好转9例(17.0%),未愈4例(7.5%).总有效率92.5%.结论 在大度数垂直斜视患者中,伴有下斜肌功能亢进者,首选下斜肌截除及前转位术,不足以矫正垂直偏斜时,联合该眼的上直肌与另一眼的下直肌后徙术,合并水平斜视时,均可Ⅰ期矫正.
目的 評價下斜肌截除及前轉位術治療大度數垂直斜視的療效.方法 以2001年1月至2009年6月收治的53例大度數垂直斜視(≥15△)患者為研究對象,均採取下斜肌截除(3～8mm)及前轉位術,即轉位于下直肌顳側緣前1 mm處.對于垂直斜度在15△～25△之間者,下斜肌截除3～5mm;垂直斜度在25△以上者,下斜肌截除6mm及前轉位後,術中照影觀察,將殘留的垂直斜度按1∶1.5的原則分配在該眼的上直肌與另一眼的下直肌(上、下直肌後徙1mm可解決1.5°的垂直偏斜);對于垂直斜度在60△以上的先天性下直肌缺如閤併小角膜患者,下斜肌截除6～8mm及前轉位術.伴有水平斜視時,按水平斜視矯正原則進行一併矯正.結果 經3～36mo隨訪,平均18mo.53例大度數垂直斜視患者Ⅰ期治愈40例(75.5%),好轉9例(17.0%),未愈4例(7.5%).總有效率92.5%.結論 在大度數垂直斜視患者中,伴有下斜肌功能亢進者,首選下斜肌截除及前轉位術,不足以矯正垂直偏斜時,聯閤該眼的上直肌與另一眼的下直肌後徙術,閤併水平斜視時,均可Ⅰ期矯正.
목적 평개하사기절제급전전위술치료대도수수직사시적료효.방법 이2001년1월지2009년6월수치적53례대도수수직사시(≥15△)환자위연구대상,균채취하사기절제(3～8mm)급전전위술,즉전위우하직기섭측연전1 mm처.대우수직사도재15△～25△지간자,하사기절제3～5mm;수직사도재25△이상자,하사기절제6mm급전전위후,술중조영관찰,장잔류적수직사도안1∶1.5적원칙분배재해안적상직기여령일안적하직기(상、하직기후사1mm가해결1.5°적수직편사);대우수직사도재60△이상적선천성하직기결여합병소각막환자,하사기절제6～8mm급전전위술.반유수평사시시,안수평사시교정원칙진행일병교정.결과 경3～36mo수방,평균18mo.53례대도수수직사시환자Ⅰ기치유40례(75.5%),호전9례(17.0%),미유4례(7.5%).총유효솔92.5%.결론 재대도수수직사시환자중,반유하사기공능항진자,수선하사기절제급전전위술,불족이교정수직편사시,연합해안적상직기여령일안적하직기후사술,합병수평사시시,균가Ⅰ기교정.
Objective To evaluate the patient's efficacy whose large degree's vertical strabismus treated by the myectomy and anterior displacement of inferior oblique surgery. Methods Included 53 patients with large degrees vertical deviation (≥ 15△) who treated by our department from January 2001 to June 2009 as the research object. All were treated by the myectomy (3-8mm) and anterior displacement of inferior oblique surgery, that was translocate the muscle 1mm before the temporal margin of inferior rectus. For the patients whose vertical gradient between the 15 △-25 △, the inferior oblique to be cut 3-5mm; For those patients whose vertical gradient above 25△, intraoperative observed after the inferior oblique to be cut 6mm and anterior displacement of inferior oblique surgery, then distribute the vertical gradient of the residual to the superior rectus /another inferior rectus of the eye according to principle of 1:1.5 (The upper and lower rectus moved back 1mmcan resettle the vertical deviation 1.5°). For the congenital absence of inferior rectus muscle in patients concurrent microcomea whose vertical gradient above 60△, the inferior oblique to be cut 6-8mm and anterior displacement of inferior oblique surgery. When accompanied horizontal strabismus, it was to restructure the strabismus according to principle of the horizontal strabismus at the same time. Results After 3-36mo reciprocal, with an average 18mo, 53 cases of vertical strabismus in patients with large degrees of stage Ⅰ cured 40 cases (75.5%), improved in 9 cases (17.0%), healed in 4 cases (7.5%). The total effective rate was 92.5%. Conclusions The large degree vertical strabismus patients who accompanied by inferior oblique hyperfunction,the first choice is the myectomy and anterior displacement of inferior oblique surgery. If it is insufficient to correct the vertical deviation, At the same time move back the superior rectus of the eye or move back inferior rectus of another eye. When combined with horizontal strabismus, all can receive stage Ⅰ correction.
