手术治疗儿童先天性眼球震颤  

Surgical treatment of fourty-three cases with congenital nystagmus in children

作　　者：李世莲[1] 叶婴茀[1] 汤洪[1] 乔彤[1] 黄明泉[1] 

机构地区：[1]武汉市儿童医院眼科,武汉430016

出　　处：《中国实用眼科杂志》2005年第5期533-534,共2页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨儿童先天性眼球震颤的手术方法及手术治疗效果。方法回顾性分析采用手术治疗的儿童先天性水平性眼球震颤43例。冲动型29例采用Anderson法矫正;钟摆型14例行双眼内、外直肌后巩膜固定术,其中7例合并斜视者,联合双眼内直肌或外直肌后徙术。结果手术后正前方眼球基本不颤12例(27.91%),减轻29例(67.44%),无变化2例(4.65%)。代偿头位消失11例(39.29%),减轻17例(60.71%)。41例视力提高。11例外斜视5例矫正为正位,6例欠矫;2例外上斜无改善;1例内斜视欠矫。无任何并发症发生。结论儿童先天性眼球震颤,根据不同的眼震类型可选择不同的手术方式,钟摆型采用直肌后巩膜固定术,冲动型采用Anderson法矫正,大多数病例可获得好的疗效。Objective To evaluate the method and effect of surgery on the patient with congential nystagmus.Methods A retrospective study of 43 patients with congenital horizontal nystagmus was reviewed.29 patients with jerk nystagmus underwent Anderson′s technique.14 patient with pendular nystagmus underwent posterior fixation suture of the rectus muscles and,of these,7 cases associated with strabismus underwent bilateral medial or lateral rectus recession.Results Elimination in nystagmus were observed in 12 patients(27.91%),and decrease were observed in 29 patients(67.44%)and there was no change in 2 patients(4.65%).The postoperative visual acuity increased in 41 cases(82 eyes).The compensatory head posture in 11 patients(39.29%)was disappeared and improvement was seen in 17 patients(60.71%).In 11 patients associated with exotropia,5 cases achieved aligned,6 cases were undercorrected.2 patients associated with exotropia and hypertropia showed no change in strabismus.1 patient associated with esotropia was undercorrected.No complication was present in all patients.Conclusions The surgical method of children′s congenital nystagmus is determined according to the different nystagmus type.Anderson′s technique is performed on jerk nystagmus,posterior fixation suture of rectus muscles is performed on pendular nystagmus.Majority can acquire the good curative effect after surgery.

关 键 词：手术治疗 儿童 先天性眼球震颤 直肌后巩膜固定术 

分 类 号：R777.46[医药卫生—眼科] R779.6[医药卫生—临床医学]