土耳其人Duane眼球后退综合征的临床特点及手术疗效分析
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Clinical features and surgical outcomes of Duane retraction syndrome in Turkish patients
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    摘要:

    目的:分析Duane眼球后退综合征(DRS)患者的临床特点及手术疗效。

    方法:评估94例DRS患者临床数据。记录完整的眼科数据,包括年龄、性别、侧位、DRS类型、偏角、异常头部姿势(AHP)、眼球后退、过冲及手术入路类型。

    结果:患者年龄为15.4±9.18岁,其中78例男性,16例女性。单侧和双侧受累分别为87% 和13%。在单侧DRS患者中,左眼占65%。94例患者中,59.5%的患者为I型,29.7%的患者为II型,8.5%的患者为III型,2.1%的患者为IV型。大多数患者(36,38%)为嗜热性,43例(96%)患者术前AHP出现10°以上。有40例(43%)患者出现过度调校,通常为II型。对45例(48%)患者进行手术治疗。共32例(78%)行水平直肌手术后获得了较好疗效,24例(53%)患者AHP改善。

    结论:侧直肌的Y分裂和后榫固定在有明显过校的情况下都有令人满意的结果。垂直直肌转位增强术在限制外展方面取得了最佳效果。

    Abstract:

    AIM: To analyze the clinical features and surgical outcomes of Duane retraction syndrome(DRS)patients.

    METHODS: The clinical data of 94 DRS patients were evaluated. Complete ophthalmic data including age, sex, laterality, the type of DRS, angle of deviation, abnormal head posture(AHP), globe retraction, overshoots and the type of surgical approach were recorded.

    RESULTS: The average age of patients was 15.4±9.18 years, and there were 78 males and 16 females. Unilateral and bilateral involvement were found in 87% and 13% of patients, respectively. In unilateral DRS patients, 65% left eyes predominance were observed. Of the 94 patients, 59.5% of the patients were type I, 29.7% of the patients were type II, 8.5% of the patients were type III and 2.1% of the patients were type IV. Most of the patients were 36(38%)esotropic and AHP over 10° was noted in 43(96%)patients, preoperatively. There were 40(43%)patients with overshoots which were more common in type II. Surgery was performed to 45(48%)patients.

    CONCLUSION: An excellent surgical outcome was obtained in 32(78%)patients that underwent horizontal rectus surgery and AHP improved in 24(53%)patients. Y-splitting and posterior tenon fixation of lateral rectus both have satisfactory outcomes in the presence of significant overshoots. Foster augmentation with vertical rectus transposition achieved optimal results in abduction limitation.

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Ceylan OM, Turk A, Gökce G, Ayyıldız Ö,Mutlu FM, Altinsoy HI.土耳其人Duane眼球后退综合征的临床特点及手术疗效分析.国际眼科杂志 2019;19(5):714-718,DOI:10.3980/j. issn.1672-5123.2019.5.02

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  • 收稿日期:2018-09-03
  • 最后修改日期:2019-01-09
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  • 在线发布日期: 2019-04-22
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