CAJ | 학술논문

目的：探讨上斜肌劈开延长术治疗A型斜视的临床疗效。方法回顾性系例病例研究。收集A型斜视患者7例，均行双眼上斜肌劈开延长术联合水平斜视矫正术。随访4～10个月。手术前后分别测量患者第一眼位水平斜视度、A征程度、眼底旋转程度。上斜肌亢进分级为+1～+4。采用Wilcoxon秩和检验对数据进行分析。结果7例患者均一次手术矫正至正位，水平斜视度在±10△之内。A征均治愈。上斜肌亢进程度由术前平均+2改善至术后平均0；眼底照相结果显示，由术前平均内旋2.5°，改善至术后平均外旋2.0°，没有患者表现为主观外旋。2例术前有代偿头位的患者，术后代偿头位消失。患者术前均无垂直斜视，术后亦未出现垂直斜视。结论上斜肌劈开延长术可有效改善A型斜视和上斜肌亢进，是一种安全、有效的上斜肌减弱方法。
목적：탐토상사기벽개연장술치료A형사시적림상료효。방법회고성계례병례연구。수집A형사시환자7례，균행쌍안상사기벽개연장술연합수평사시교정술。수방4～10개월。수술전후분별측량환자제일안위수평사시도、A정정도、안저선전정도。상사기항진분급위+1～+4。채용Wilcoxon질화검험대수거진행분석。결과7례환자균일차수술교정지정위，수평사시도재±10△지내。A정균치유。상사기항진정도유술전평균+2개선지술후평균0；안저조상결과현시，유술전평균내선2.5°，개선지술후평균외선2.0°，몰유환자표현위주관외선。2례술전유대상두위적환자，술후대상두위소실。환자술전균무수직사시，술후역미출현수직사시。결론상사기벽개연장술가유효개선A형사시화상사기항진，시일충안전、유효적상사기감약방법。
Objective To describe the results using split tendon superior oblique elongation with horizontal rectus muscle surgery for A-pattern strabismus. Methods Seven patients with A-pattern strabismus who underwent superior oblique split tendon elongation procedure were retrospectively reviewed. The deviation angle was measured in the primary position , and 25° up-gaze and 25° down-gaze positions pre- and postoperatively. The objective torsion was recorded with fundus photography before and after surgery. Superior oblique over-action (SOOA) was graded from +1 to +4. All patients underwent bilateral superior oblique split tendon lengthening with horizontal rectus muscle surgery. A Wilcoxon matched-pairs signed rank test was used to analyze the data. The follow-up time was from 4 to 10 months. Results Postoperatively, 7 patients showed good alignment in the primary position with a deviation angle less than 10 PD. All A-patterns collapsed into less than 10PD. SOOA improved from +2.71 to +0.71. Fundus photography showed 5.17° less intorsion postoperatively. No patient complained of torsional diplopia after surgery. No new vertical deviation was observed in any of the 7 patients after surgery. Conclusion Superior oblique split tendon elongation effectively improves A-pattern and SOOA. Superior oblique split tendon lengthening is a safe and effective superior oblique weakening procedure.