分离性垂直偏斜的显微手术治疗  

Microsurgery on dissociated vertical deviation

作　　者：楚瑞雪[1] 张静[2] 万晓梅[2] 宫华青[2] 

机构地区：[1]青岛大学,山东省青岛市266071 [2]山东省眼科研究所,山东省青岛市266071

出　　处：《眼科新进展》2011年第3期283-285,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨分离性垂直偏斜(dissociated vertical deviation,DVD)的手术治疗方式,以便寻求最佳的治疗效果。方法 对41例(79眼)DVD患者进行显微外科手术治疗。并根据不同的上斜程度,对双眼上直肌行不等的超常量后徙(限定最大量≤7mm);对合并有水平眼位偏斜及下斜肌功能亢进伴或不伴Bielschowsky(+)者,分别行水平斜视矫正或下斜肌断腱联合部分切除术。术后随访1个月～2a观察手术效果。结果 17例(32眼)眼球正位,19例(37眼)仍存在小度数上斜(≤8△),5例(10眼)存在9△～10△欠矫,远期满意率87.8%,手术效果良好。结论 眼科手术显微镜下充分分离DVD患者的上直肌及其周围关联的组织;根据上斜的程度不同,对其双上直肌行不等的超常量后徙,术后疗效较好。Objective To probe into the most efficient surgical treatment of dissociated vertical deviation（DVD）.Methods Microsurgery was performed in 41 cases（79 eyes） with DVD.According to the degree of hypertropia,extra large recession of superior rectus muscle（no more than 7 mm） were made;The cases who combined with horizontal strabismus,inferior oblique muscle overaction or Bielschowsky（＋） were performed the horizontal strabismus correction and partial inferior oblique muscle tenotomy.The follow-up time was from 1 month to 2 years,the surgical effects were observed.Results The eyeballs in 17 cases（32 eyes） had no obvious elevation movement,19 cases（37 eyes） had upslope of small degrees（≤8△）,5 cases（10 eyes） were from 9△ to 10△,the long-term satisfactory rate was 87.8%,the surgical effects were well.Conclusion The superior rectus and the tissues around it are separated thoroughly under ophthalmic operating microscope,the extra large recession of superior rectus muscle can get efficient results.

关 键 词：分离性垂直偏斜 显微手术 上直肌后徙 

分 类 号：R778.1[医药卫生—眼科]