Duane眼球后退综合征21例手术治疗临床观察  

Clinical analysis of surgical treatment for 21 cases with Duane＇s retraction syndrome

作　　者：周畅达 张小红 秦剑英[1] 陈忠飞[1] 程福荣[1] 

机构地区：[1]河北沧州眼科医院,061001 [2]承德区学管院影像教学实验室,承德市

出　　处：《中华眼外伤职业眼病杂志》2011年第9期660-663,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨眼球后退综合征（DRS）的临床特点和手术方法。方法21例眼球后退综合征根据术前不同的斜视度、斜视类型、牵拉实验结果、同视机检查结果以及眼球内转时是否伴有上射和（或）下射现象，在解除限制因素的前提下分别采取内直肌后退或悬吊术，外直肌后退或悬吊术，内外直肌同时后退或悬吊术以及外直肌Y型劈开联合后退术。结果术后内转眼上射和（或）下射现象及代偿头位有不同程度的改善或消失。14例内斜视术后12例斜视度≤10^△，2例斜视度〉10△.其中2例在行内直肌后退术后出现外斜视。7例外斜视中，5例行外直肌后退或悬吊术，2例行外直肌Y型劈开联合后退术，其中6例术后斜视度≤10△，1例斜视度〉10△。结论在解除限制因素的前提下，水平直肌大量后退可以消除或改善代偿头位，亦可恢复原在位的眼位。对于斜视度≤20△且有代偿头位的DRS患者，可以戴棱镜矫正。直肌Y型分开联合后退术或水平直肌同时后退术在解决内转眼上射和（或）下射现象时有显著疗效。Objective To investigate the characters of Duane＇s retraction syndrome （DRS） and the individualized surgical plan. Methods According to the character of DRS, we treated it with four methods ： the medial rectus recession combined with ventrofixation, external rectus recession combined with ventrofix- ation, medial rectus and external rectus muscle simultaneously combined ventrofixation or external rectus muscle Y-shaped division. Results Upshoot and/or downshoot phenomenon and the head compensation position improved or cured postoperatively. Deviation angle of 12 patients was ≤ 10 △ in 14 patients with esotro- pia. Two cases appeared exotropia after medical rectus recession. Deviation angle of 6 cases of 7 patients with exotropia was ≤ 10△. In which five cases were performed external rectus muscle recession combined with ventrofixation; ：2 cases were performed external rectus muscle Y shaped division. Conclusion Exclu- ding the limiting factor, adequate recession of horizontal rectus could improve or remove the compensation head position. To help the patient with the head compensation position and strabismus ≤20△ ,we could give prismatic glasses. The curative effect is notable when the rectus Y shaped division with recession or both hor- izontal rectus recession simultaneously was done for upshoot or downshoot phenomenon.

关 键 词：DUANE眼球后退综合征 手术 眼外肌 

分 类 号：R779.6[医药卫生—眼科]