中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2015年
6期
424-428
,共5页
斜视%眼球运动障碍%动眼肌%眼外科手术
斜視%眼毬運動障礙%動眼肌%眼外科手術
사시%안구운동장애%동안기%안외과수술
Strabismus%Ocular motility disorders%Oculomotor muscles%Ophthalmologic surgical procedures
目的 探讨下斜肌肌腹前转位术联合上直肌后徙手术治疗下直肌缺如的临床疗效.方法 回顾性系列病例研究.收集2007年10月至2010年7月应用下斜肌肌腹前转位联合上直肌后徙术治疗的5例下直肌缺如继发上斜视的患者资料.分别比较患者手术前后眼位、眼球运动、代偿头位的变化,并做长期随访观察,随访时间6～18个月,平均10.8个月.结果 术后4例正前方眼位正位,1例过矫10个视乳头直径,眼球运动下转受限平均由-3.0改善为-1.6,上转出现不同程度受限平均为-2.0.2例患者术前有代偿头位,术后代偿头位均消失.5例患者术前术后眼底照相检查无明显旋转斜度变化.5例患者均对外观的改善满意,随访结果稳定,未再行其他手术治疗.结论 下斜肌肌腹前转位手术联合上直肌后徙在改善下直肌缺如的上斜视有一定效果,并且手术可一期完成.术中无需切断下斜肌,手术过程较便捷,可减小术中出血的危险.
目的 探討下斜肌肌腹前轉位術聯閤上直肌後徙手術治療下直肌缺如的臨床療效.方法 迴顧性繫列病例研究.收集2007年10月至2010年7月應用下斜肌肌腹前轉位聯閤上直肌後徙術治療的5例下直肌缺如繼髮上斜視的患者資料.分彆比較患者手術前後眼位、眼毬運動、代償頭位的變化,併做長期隨訪觀察,隨訪時間6～18箇月,平均10.8箇月.結果 術後4例正前方眼位正位,1例過矯10箇視乳頭直徑,眼毬運動下轉受限平均由-3.0改善為-1.6,上轉齣現不同程度受限平均為-2.0.2例患者術前有代償頭位,術後代償頭位均消失.5例患者術前術後眼底照相檢查無明顯鏇轉斜度變化.5例患者均對外觀的改善滿意,隨訪結果穩定,未再行其他手術治療.結論 下斜肌肌腹前轉位手術聯閤上直肌後徙在改善下直肌缺如的上斜視有一定效果,併且手術可一期完成.術中無需切斷下斜肌,手術過程較便捷,可減小術中齣血的危險.
목적 탐토하사기기복전전위술연합상직기후사수술치료하직기결여적림상료효.방법 회고성계렬병례연구.수집2007년10월지2010년7월응용하사기기복전전위연합상직기후사술치료적5례하직기결여계발상사시적환자자료.분별비교환자수술전후안위、안구운동、대상두위적변화,병주장기수방관찰,수방시간6～18개월,평균10.8개월.결과 술후4례정전방안위정위,1례과교10개시유두직경,안구운동하전수한평균유-3.0개선위-1.6,상전출현불동정도수한평균위-2.0.2례환자술전유대상두위,술후대상두위균소실.5례환자술전술후안저조상검사무명현선전사도변화.5례환자균대외관적개선만의,수방결과은정,미재행기타수술치료.결론 하사기기복전전위수술연합상직기후사재개선하직기결여적상사시유일정효과,병차수술가일기완성.술중무수절단하사기,수술과정교편첩,가감소술중출혈적위험.
Objective To evaluate the effect of integrated anteriorization of inferior oblique muscle combined with recession of superior rectus to treat large hypertropia following absence of inferior rectus.Methods It was a retrospective case series study.Integrated anteriorization of inferior oblique muscle means transposing inferior oblique muscle 8-10 mm posterior to the insertion directly to original insertion of inferior rectus without myotomy.We reviewed 5 patients with absence of inferior rectus muscle,who treated by integrated anteriorization of inferior oblique muscle combined with recession of superior rectus.The pre and post-operative vertical deviation in primary position,ocular motility,and abnormal head position were compared.The patients were followed up from 6 to 18 months,with average as 10.8 months.Results Postoperatively,4 patients showed orthophoria in primary position and 1 patient had 10 PD hypotropia.The infraduction deficits improved from-3.0 to-1.6.Meanwhile,there had been an average of -2.0 mild supraduction limitation.Abnormal head position (AHP) disappeared in 2 patients with AHP before operation.All the patients showed no change of cyclodeviation on fundus photograph.5 patients were satisfied with the improvement of the appearance,and the follow-up results were stable,no other surgery again.Conclusions Integrated anteriorization of inferior oblique muscle combined with recession of superior rectus was an effective surgical selection to treat hypertropia with absence of inferior rectus muscle.This procedure doesn't need to cut off the inferior oblique muscle.The more convenient surgical procedure can reduce the risk of bleeding.
