两种固定性内斜视手术方式效果的比较  

Effect comparison of two fixed esotropia operation method

作　　者：魏艳丽[1] 安晓巨[1] 孙强[1] 叶剑[1] 

机构地区：[1]第三军医大学大坪医院眼科专科医院,中国重庆市400042

出　　处：《国际眼科杂志》2012年第8期1558-1559,共2页International Eye Science

摘　　要：目的:比较两种固定性内斜视手术方案的术后效果。方法:回顾性分析我院11a来26例45眼固定性内斜视患者手术治疗过程。2000-01/2006-12采用内直肌断腱联合外直肌超常量缩短术式(术式I)治疗17眼,2007-01/2010-12采用内直肌断腱联合外直肌折叠并固定于颞侧眶骨膜术(术式Ⅱ)治疗28眼。结果:采用术式I的17眼,术后第1d有4眼发现内斜>15°,即行外直肌眶骨膜固定于过矫5°～10°,术后随访1a左右眼位外斜5°左右。13眼随访6～18mo,其中7眼复发内斜10°～30°,均行外直肌眶骨膜固定并过矫于外斜5°～10°,术后随访1a以上眼位在外斜5°左右。采用术式Ⅱ的28眼,术后第1d复查发现眼位均过矫与术中设计情况类似,出院后随访1～2a术眼眼位均在外斜5°左右,2例随访3～4a,眼位轻微外斜5°以内。结论:常规固定性内斜视手术治疗不能达到较好的治疗效果且逐渐回退,内直肌断腱联合外直肌超常量缩短术式手术效果良好,安全简便,手术成功率高,术后长期随访回退率低,是值得推广的手术方式。AIM： To compare the effects of two fixedesotropia operation method. METHODS： Retrospectively analyzed the operation courses of 26 cases（45 eyes） with fixed esotropia in the last 11 years. During January 2000 to December 2006, surgeries were done for 17 eyes to cut off tendon of medial rectus and shorten lateral rectus for an excessive amount （Surgery I）. During January 2007 to December 2010, surgeries were taken for 28 eyes to cut off tendon of medial rectus, overlap lateral rectus and fix it to orbital periosteum on the side of temporal bone （Surgery II）. RESULTS：Among the 17 eyes on which Surgery I was performed, it was found that 4 eyes turned inward for more than 15 degrees 1 day after the surgery. Then surgeries were taken immediately to fix lateral rectus on orbital periosteum so that the eyes could be over corrected for 5-10 degrees. During follow-up about 1 year after surgery, the eyes were over corrected for about 5-10 degrees. During follow-up of the other 13 eyes in 6-18 months after surgery, esotropia of 10-30 degree occurred on 7 eyes. Surgeries were practiced in all of them to fix lateral rectus on orbital periosteum and over correct the eyes for 5-10 degrees. During their visits in 1 year after surgery, the eyes were over corrected for about 5 degrees. Of the 28 eyes on which Surgery II were performed, it was found that all of the eyes were over corrected, and were similar to the surgical designs. During their visits in 1 -2 years after surgery, the eyes were over corrected for about 5 degrees. Patients of 2 cases visited us for 3-4 years, and their eyes were slightly over corrected for within 5 degrees. CONCLUSION： Regular surgical treatment for fixed esotropia could not achieve better effect, and the surgical effect will regress in time. The surgery to cut off tendon of medial rectus and shorten lateral rectus for an excessive amount has achieved better effect. It is safer and less difficult. The rate of success is high. And, the rate of regression is low according to stati

关 键 词：高度近视 固定性斜视 内斜视 手术 

分 类 号：R779.6[医药卫生—眼科]