中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
10期
1230-1233
,共4页
上斜肌功能亢进%垂直斜视%A型斜视%断腱术%肌腱部分切除术
上斜肌功能亢進%垂直斜視%A型斜視%斷腱術%肌腱部分切除術
상사기공능항진%수직사시%A형사시%단건술%기건부분절제술
Superior oblique overaction%Vertical deviation%A-pattern strabismus%Superior oblique tenotomy%Superior oblique partial tenectomy
目的 探讨上斜肌亢进患者的临床特征,以及上斜肌断腱术与部分切除术治疗上斜肌功能亢进的疗效.方法 对2008年6月至2013年11月在四川大学华西医院就诊的167例(306只眼)上斜肌功能亢进患者行上斜肌断腱术与部分切除术,并比较手术前后上斜肌功能、垂直方向斜视度及A征矫正情况等,以此综合评价上斜肌断腱术与部分切除术治疗上斜肌亢进的疗效.结果 167例(306只眼)上斜肌亢进患者平均年龄为(14.92±7.13)岁,108只眼行上斜肌断腱术,198只眼行上斜肌肌腱部分切除术.其中,21只眼术后出现上斜肌功能不足,占6.9％ (21/306);26只眼术后上斜肌功能仍然呈不同程度亢进,占8.5％ (26/306);38只眼继发下斜肌功能亢进,占12.4％ (38/306).131例伴发A型外斜视的患者中,有21例患者术后仍为A征,但A征均较术前明显减小.垂直方向斜视度矫正在不同注视眼位分别为:正前方视近均值为6.96△、正前方视远为7.36△、眼球上转为7.78△、眼球下转为9.27△.此外,17例伴有A外斜的患者术后转变为V型外斜视,11例患者出现10△以内垂直方向的斜视.结论 上斜肌功能亢进患者常伴有A型外斜视;上斜肌断腱术与部分切除术能有效矫正上斜肌功能亢进、A征,单眼手术可有效矫正垂直方向的斜视度.
目的 探討上斜肌亢進患者的臨床特徵,以及上斜肌斷腱術與部分切除術治療上斜肌功能亢進的療效.方法 對2008年6月至2013年11月在四川大學華西醫院就診的167例(306隻眼)上斜肌功能亢進患者行上斜肌斷腱術與部分切除術,併比較手術前後上斜肌功能、垂直方嚮斜視度及A徵矯正情況等,以此綜閤評價上斜肌斷腱術與部分切除術治療上斜肌亢進的療效.結果 167例(306隻眼)上斜肌亢進患者平均年齡為(14.92±7.13)歲,108隻眼行上斜肌斷腱術,198隻眼行上斜肌肌腱部分切除術.其中,21隻眼術後齣現上斜肌功能不足,佔6.9％ (21/306);26隻眼術後上斜肌功能仍然呈不同程度亢進,佔8.5％ (26/306);38隻眼繼髮下斜肌功能亢進,佔12.4％ (38/306).131例伴髮A型外斜視的患者中,有21例患者術後仍為A徵,但A徵均較術前明顯減小.垂直方嚮斜視度矯正在不同註視眼位分彆為:正前方視近均值為6.96△、正前方視遠為7.36△、眼毬上轉為7.78△、眼毬下轉為9.27△.此外,17例伴有A外斜的患者術後轉變為V型外斜視,11例患者齣現10△以內垂直方嚮的斜視.結論 上斜肌功能亢進患者常伴有A型外斜視;上斜肌斷腱術與部分切除術能有效矯正上斜肌功能亢進、A徵,單眼手術可有效矯正垂直方嚮的斜視度.
목적 탐토상사기항진환자적림상특정,이급상사기단건술여부분절제술치료상사기공능항진적료효.방법 대2008년6월지2013년11월재사천대학화서의원취진적167례(306지안)상사기공능항진환자행상사기단건술여부분절제술,병비교수술전후상사기공능、수직방향사시도급A정교정정황등,이차종합평개상사기단건술여부분절제술치료상사기항진적료효.결과 167례(306지안)상사기항진환자평균년령위(14.92±7.13)세,108지안행상사기단건술,198지안행상사기기건부분절제술.기중,21지안술후출현상사기공능불족,점6.9％ (21/306);26지안술후상사기공능잉연정불동정도항진,점8.5％ (26/306);38지안계발하사기공능항진,점12.4％ (38/306).131례반발A형외사시적환자중,유21례환자술후잉위A정,단A정균교술전명현감소.수직방향사시도교정재불동주시안위분별위:정전방시근균치위6.96△、정전방시원위7.36△、안구상전위7.78△、안구하전위9.27△.차외,17례반유A외사적환자술후전변위V형외사시,11례환자출현10△이내수직방향적사시.결론 상사기공능항진환자상반유A형외사시;상사기단건술여부분절제술능유효교정상사기공능항진、A정,단안수술가유효교정수직방향적사시도.
Objective To evaluate the efficacy of superior oblique partial tenectomy and tenotomy in the treatment of superior oblique overaction with respect to collapse of A-pattern strabismus.Methods Retrospectively reviewed 167 patients (306 eyes) who had superior oblique (SO) weakening with either SO tenotomy or SO partial tenectomy and had been followed for a mean follow-up of 137 days.The degree of A-patter,vertical deviation and SO function were analyzed in all patients before and after surgery.Results A total of 167 patients (mean age,14.92±7.13 years) underwent SO weakening,of whom 83 patients (108 eyes) had been treated with superior oblique tenotomy and 112 patients (198 eyes) with superior oblique partial tenectomy.The mean preoperative amount of A-pattern for all patients was 20.37±10.04△ with a mean collapse of (15.96±10.22△,0 to 33△).The mean degree of preoperative vertical deviation in the group were 6.96△ in the primary position at near distance,7.36△ in the primary position at distance,7.78△ of 25-degree upgaze,and 9.27△ of 25-degree downgaze at distance.There were no surgical complications,except in 11 patients,who manifested mild inferior oblique overaction.Conclusions The results show that superior oblique tenotomy and superior oblique partial tenectomy can effectively collapse A-pattern deviation with mild to moderate SO overaction and reduce associated vertical deviation.
