CAJ | 학술논문

间歇性外斜视手术治疗方式主要分为对称性手术(双眼外直肌后徙或双眼内直肌缩短)和非对称性手术(单眼外直肌后徙联合内直肌缩短).外直肌后徙术是最常采用的方法,而外直肌后徙的手术量一直存在争议.通常对于斜视度数35Δ ～40Δ的外斜视,双眼外直肌的后徙量为7～8 mm;对于斜视度＞40Δ的外斜视,采用外直肌后徙联合内直肌缩短术.但部分学者对大角度外斜视(斜视度数＞50Δ)采用双眼外直肌或中等角度的外斜视(斜视度数为30Δ～ 35Δ)采用单眼外直肌超常量后徙的方式,后徙量为9 ～14 mm,这给临床工作带来一定困扰.为此,我们针对外直肌后徙术常规和超常量后徙这个话题,提出了几个大家关注的问题,并进行了较深入探讨,以期为临床提供参考借鉴.
간헐성외사시수술치료방식주요분위대칭성수술(쌍안외직기후사혹쌍안내직기축단)화비대칭성수술(단안외직기후사연합내직기축단).외직기후사술시최상채용적방법,이외직기후사적수술량일직존재쟁의.통상대우사시도수35Δ ～40Δ적외사시,쌍안외직기적후사량위7～8 mm;대우사시도＞40Δ적외사시,채용외직기후사연합내직기축단술.단부분학자대대각도외사시(사시도수＞50Δ)채용쌍안외직기혹중등각도적외사시(사시도수위30Δ～ 35Δ)채용단안외직기초상량후사적방식,후사량위9 ～14 mm,저급림상공작대래일정곤우.위차,아문침대외직기후사술상규화초상량후사저개화제,제출료궤개대가관주적문제,병진행료교심입탐토,이기위림상제공삼고차감.
Surgical treatments of intermittent exotropia include symmetric bilateral lateral rectus recession,symmetric bilateral medial rectus resection,asymmetric monocular lateral rectus recession and/or medial rectus resection,in which lateral rectus recession is the most common method.The maximum amount of lateral rectus recession,however,is still controversial.Bilateral lateral rectus recession 7-8 mm for 35Δ-40Δ exotropia and unilateral lateral rectus recession and medial rectus resection for exotropia larger than 40Δ are suggested by most doctor usually.But some other doctors advocated augmented bilateral lateral rectus recession (9-14 mm) for exotropia larger than 50Δ or augmented unilateral lateral rectus recession for moderate angle exotropia (30Δ-35Δ),which brought confusion in practical clinical work.In this paper,we'll focus on the amount of lateral rectus recession,and discuss several common issues related to augmented lateral rectus recession,in order to provide references for the majority of clinicians.