A-V综合征的手术探讨  

Surgical treatment of A and V patterns

作　　者：张伟[1] 赵堪兴[1] 郭新[1] 杜翠琴[1] 宋坤英[1] 马惠芝[1] 朱丽娜[1] 岳以英[1] 

机构地区：[1]天津市眼科医院,天津300040

出　　处：《中国实用眼科杂志》2004年第11期921-923,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨A-V综合征的特征及手术效果。方法138例A-V综合征患者中104例给予手术处理,其中V征90例,依据是否伴有下斜肌功能亢进及亢进程度,行下斜肌切断/部分切除或水平直肌垂直移位术;A征14例,依据是否伴有上斜肌功能亢进、双眼视功能状况以及是否伴有内旋偏斜,行上斜肌切断或水平直肌垂直移位术。所有患者常规矫正相应的水平斜度。观察手术前后的眼位、斜肌功能和双眼视觉。结果下斜肌切断/部分切除适用于下斜肌功能亢进～的V征,水平直肌垂直移位术适用于无下斜肌功能亢进或下斜肌功能亢进+的V征。对无双眼视功能的A征患者,上斜肌亢进达到或超过者,适用于上斜肌断腱术;而双眼视功能良好,又未见内旋或上斜肌亢进程度≤+,用水平肌肉移位术效果最好。结论斜肌功能异常是A-V综合征的主要原因,应依据是否伴有斜肌功能亢进、亢进程度及双眼视情况,决定行斜肌手术或水平直肌垂直移位术。Objective To investigate the clinical features and to evaluate the effects of different surgical procedures of A-V pattern.Methods 138 cases of A-and V-patterns were studied.106 of 138 cases were performed surgery.The inferior oblique muscle weakening procedure or horizontal rectus vertical transposition were performed in 90 patients with V pattern according to the function of inferior oblique muscle.The superior oblique muscle weakening procedure or horizontal rectus vertical transposition were performed in 14 patients with A pattern according to the function of superior oblique muscle,binoclular vision,with or without intortion.Eye position,the function of oblique muscle and binocular vision before and after surgery were analyzed.Results The inferior oblique muscle weakening procedure was most effective for V pattern with overaction of inferior oblique muscle ～.The horizontal rectus vertical transposition was most effective for V pattern with overaction of inferior oblique muscle+ or without of inferior oblique muscle overaction.The tenototmy of superior oblique muscle was performed for A pattern without normal binocular vision while the function of superior oblique muscle is ～.The horizontal rectus vertical transposition was performed for A pattern with overaction of superior oblique muscle+ or without of supererior oblique muscle overaction while the binocular vision is normal and no intortion evidence was found.Conclusions The dysfunction of inferior or superior oblique muscle is the primary factor in the etiology of A-and V-patterns.Different surgical procedures should be selected according to overaction degree of oblique muscle and binocular vision.

关 键 词：亢进 肌功能 移位术 A-V综合征 上斜肌 下斜肌 双眼视功能 垂直 水平 依据 

分 类 号：R777[医药卫生—眼科] R778[医药卫生—临床医学]