CAJ | 학술논문

目的探讨直肌肌束部分转位移植矫正麻痹性斜视手术方法和治疗效果.方法总结27例麻痹性斜视行直肌肌束部分转位移植,并观察在术前、术后麻痹肌的运动情况、双眼视功能、眼球运动情况、眼位及复视消失情况等结果.结果 27例患者术后眼球运动功能有不同程度好转,除2例外全部过中线,转动1～2mm者12例、3mm者10例、4～5mm者2例、7mm者1例.术后被转位的肌肉运动正常.术后21例患者不同程度恢复了双眼视功能,其中具备Ⅰ度双眼单视功能13例,具备Ⅱ度双眼单视功能6例,2例有Ⅲ度双眼单视功能.6例同视机检测仍是单眼抑制.术后眼位正位22例,欠矫5～10度5例,23例复视消除,3例轻度改变注视方向也可消除复视.1例仍有复视不能耐受行二次手术.结论直肌肌束部分转位移植可矫正麻痹性斜视眼位,消除复视,改善眼球运动,恢复部分双眼视功能,而且睫状肌血管分离保留可减少眼前段供血不足的危险,是目前安全、可行、有效地手术方法.
목적 탐토직기기속부분전위이식교정마비성사시수술방법화치료효과.방법 총결27례마비성사시행직기기속부분전위이식,병관찰재술전、술후마비기적운동정황、쌍안시공능、안구운동정황、안위급복시소실정황등결과.결과 27례환자술후안구운동공능유불동정도호전,제2예외전부과중선,전동1～2mm자12례、3mm자10례、4～5mm자2례、7mm자1례.술후피전위적기육운동정상.술후21례환자불동정도회복료쌍안시공능,기중구비Ⅰ도쌍안단시공능13례,구비Ⅱ도쌍안단시공능6례,2례유Ⅲ도쌍안단시공능.6례동시궤검측잉시단안억제.술후안위정위22례,흠교5～10도5례,23례복시소제,3례경도개변주시방향야가소제복시.1례잉유복시불능내수행이차수술.결론 직기기속부분전위이식가교정마비성사시안위,소제복시,개선안구운동,회복부분쌍안시공능,이차첩상기혈관분리보류가감소안전단공혈불족적위험,시목전안전、가행、유효지수술방법.
Purpose To describe and evaluate the clinical effect of partical rectus muscle transplantation surgery in the treatment of paralytic strabismus.Methods the following parameters were analyzed before and after the operation for the 27 patients who underwent partial rectus muscle transplantation surgery:(1) paralytic muscle movement;(2)binocular function;(3)eye movement;(4)primary eye position;(5)the existence of diplopia.Results All the patients (27 cases) to some degree retrieved muscle functions.The ocular movement was postoperatively 1-2mm in '12 patients,3mm in 10 patients,4-5mm in 2 patients and 7mm in 1 patient.Although 6 patients remained monocular suppression,21 patients regained single binocular vision to some extent(13 for simultaneous perception,6 for fusion and 2 for stereopsis).22 patients restored straight-ahead position post operation while 5 patients were lack of correction(5-10°).The diplopia was resolved in 23 patients and in another 3 patients when they changed slightly the position of gaze.Reoperation was required in 1 patient who remained diplopia.Conclusions partial rectus muscle transplantation surgery serves as a safe and practical procedure that results in improved ocular alignment,rectifying deviation,resoning diplopia,retrieving visual function and minimizing the risk of arterial insufficiency for me anterior segment of the eye,which was proved to be an effective treatment for paralytic strabismus.