部分直肌转位治疗单条直肌完全麻痹斜视的疗效分析
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Clinical effects of partial rectus muscle transportation procedure for paralytic strabismus
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    摘要:

    目的:分析部分直肌转位术治疗单条直肌完全麻痹性斜视的临床疗效。

    方法:回顾性分析22例25眼单条直肌完全麻痹性斜视患者行部分直肌转位术,手术前后眼位、复视、代偿头位及眼球运动情况。随访6mo。

    结果:根据22例25眼患者的术前、术中检查结果,采用不同的术式组合:单纯部分直肌转位术2眼,麻痹肌的拮抗肌后退及部分直肌转位术20眼,麻痹肌的拮抗肌后退、部分直肌转位并对侧眼配偶肌后退术3眼。术后20例第一眼位完全正位,代偿头位及复视均消除,2例双眼外直肌麻痹患者轻度欠矫,分别配戴8、10三棱镜后复视及代偿头位均消失。斜视度术前100.23±42.61,术后0.82±2.67(t=10.797,P<0.001)。眼球运动评分术前-4.52±0.51分,术后-2.68±0.63分(t=-19.468,P<0.001)。

    结论:部分直肌转位术治疗单条直肌完全麻痹性斜视能有效矫正第一眼位的斜视、复视,消除代偿头位,改善眼球运动,获得满意的临床效果。

    Abstract:

    AIM: To analyze the clinical effects of partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis.

    METHODS: The conditions of 22 patients(25 eyes)who underwent partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis were retrospectively reviewed. The following data were analyzed: 1)the angle of deviation of primary position; 2)the presence of diploma in the primary position; 3)the presence of compensatory head posture; 4)the motility of the affected eye. All of the patients attended 6mo postoperative follow-up examinations.

    RESULTS: According to the results of examinations before and during operation, different operations were performed: 2 eyes were treated with partial rectus muscle transportation, 20 eyes were treated with recession of antagonistic muscle of paralytic rectus muscle combined with partial rectus muscle transportation, 3 eyes were treated with recession of antagonistic muscle, partial rectus muscle transportation and recession of yoke muscle. Twenty patients were orthotropia in the primary position, the diploma and abnormal head posture were eliminated. Two patients with binocular lateral rectus muscles paralysis were in mild undercorrection which were resolved by wearing 8 and 10 prisms respectively. The procedure improved strabismus of 25 eyes from 100.23±42.61 preoperatively to 0.82±2.67 postoperatively(t=10.797,P<0.001). Ocular movement was improved from -4.52±0.51 preoperatively to -2.68±0.63 postoperatively(t=-19.468, P<0.001).

    CONCLUSION: Partial rectus muscle transportation procedure for paralytic strabismus due to single rectus muscle paralysis can effectively correct the primary position in paralytic strabismus, eliminate the presence of diploma in primary position and abnormal head posture, and improve the ocular motility, which provides content clinical effects.

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吴小影,王洁月,李凤云.部分直肌转位治疗单条直肌完全麻痹斜视的疗效分析.国际眼科杂志, 2016,16(8):1596-1598.

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  • 收稿日期:2016-04-29
  • 最后修改日期:2016-07-04
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  • 在线发布日期: 2016-07-26
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