中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
7期
879-881
,共3页
继发性内斜%斜视手术
繼髮性內斜%斜視手術
계발성내사%사시수술
Consecutive esotropia%Strabismus surgery
目的 探讨双眼外直肌同时后徙术后引起继发性内斜视的原因及其治疗方法.方法 回顾性分析2009年6月至2013年6月在莒南县红十字光明医院诊治的17例继发性内斜视患者,均有双眼外直肌同时后徙的手术病史,并外直肌后徙的手术量为5～10 mm,其中有11例双眼外直肌后徙量≥8 mm,术后发生继发内斜视时间均＞6个月.依据患者眼球运动及视近、视远的斜视度和被动牵拉试验等选择再次手术方式,术后随访至少6个月.结果 2例行内直肌后徙手术,10例行外转受限明显眼的外直肌复位手术,2例行双眼外直肌复位手术,3例行外直肌复位联合同眼的内直肌后徙手术.17例患者术后均无复视及代偿头位,平均眼位为(-1.8±5.0)△,术后远期随访眼位为(-3.2±5.0)△,手术成功率为88.24％(15/17),所有患者均对术后眼位满意.结论 双眼外直肌大量后徙易引起继发性内斜视,依据眼球运动及视近、视远的斜视度选择不同的手术方式,可有效矫正由双眼外直肌同时后徙引起的继发性内斜视.
目的 探討雙眼外直肌同時後徙術後引起繼髮性內斜視的原因及其治療方法.方法 迴顧性分析2009年6月至2013年6月在莒南縣紅十字光明醫院診治的17例繼髮性內斜視患者,均有雙眼外直肌同時後徙的手術病史,併外直肌後徙的手術量為5～10 mm,其中有11例雙眼外直肌後徙量≥8 mm,術後髮生繼髮內斜視時間均＞6箇月.依據患者眼毬運動及視近、視遠的斜視度和被動牽拉試驗等選擇再次手術方式,術後隨訪至少6箇月.結果 2例行內直肌後徙手術,10例行外轉受限明顯眼的外直肌複位手術,2例行雙眼外直肌複位手術,3例行外直肌複位聯閤同眼的內直肌後徙手術.17例患者術後均無複視及代償頭位,平均眼位為(-1.8±5.0)△,術後遠期隨訪眼位為(-3.2±5.0)△,手術成功率為88.24％(15/17),所有患者均對術後眼位滿意.結論 雙眼外直肌大量後徙易引起繼髮性內斜視,依據眼毬運動及視近、視遠的斜視度選擇不同的手術方式,可有效矯正由雙眼外直肌同時後徙引起的繼髮性內斜視.
목적 탐토쌍안외직기동시후사술후인기계발성내사시적원인급기치료방법.방법 회고성분석2009년6월지2013년6월재거남현홍십자광명의원진치적17례계발성내사시환자,균유쌍안외직기동시후사적수술병사,병외직기후사적수술량위5～10 mm,기중유11례쌍안외직기후사량≥8 mm,술후발생계발내사시시간균＞6개월.의거환자안구운동급시근、시원적사시도화피동견랍시험등선택재차수술방식,술후수방지소6개월.결과 2례행내직기후사수술,10례행외전수한명현안적외직기복위수술,2례행쌍안외직기복위수술,3례행외직기복위연합동안적내직기후사수술.17례환자술후균무복시급대상두위,평균안위위(-1.8±5.0)△,술후원기수방안위위(-3.2±5.0)△,수술성공솔위88.24％(15/17),소유환자균대술후안위만의.결론 쌍안외직기대량후사역인기계발성내사시,의거안구운동급시근、시원적사시도선택불동적수술방식,가유효교정유쌍안외직기동시후사인기적계발성내사시.
Objective To analyze the cause and surgical treatment of consecutive esotropia following bilateral lateral rectus recession.Methods Seventeen patients were operated on for consecutive esotropia which persisted over 6 months after exotropia surgery were analyzed retrospectively from June 2009 to July 2013.All patients had undergone first surgery with recession of both lateral rectus muscles,the lateral rectus muscles were recessed from 5 mm to 10 mm,and there were 11 patients' recession was more than 8mm.Different operation was performed which depended on eye movement,deviation and force duction.All patients were followed up for 1 year.Results Two patients were treated with recession of medial rectus; 10 patients with abduction impairment were treated with advancement at insertion of lateral rectus muscle on one eye,while 2 patients were on both eye; the other patients with large angle esotropia in primary position were treated with advancement of lateral rectus combined with recession of medial rectus.Postoperatively,17 patients were orthophoria without diplopia or abnormal head position,mean deviation was (-1.8±5.0)△,(-3.2±5.0)△ as long term follow up.The success rate was 88.24％ (15/17).All patients were satisfied with the surgical correction and no one needed more surgery.Conclusions The large recession of bilateral lateral rectus muscle maybe cause esotropia.Different surgical management which depends on eye movement,deviation and force duction is effective for consecutive esotropia.
