变量下斜肌移位术治疗下斜肌功能过强的远期效果观察  

Late result after graded transposition of the inferior oblique muscle for eliminating inferior oblique overaction

作　　者：汪泽[1] 孟祥成[2] 张利光[1] 李世洋[1] 王殿义[1] 孙丙池 

机构地区：[1]解放军第91医院眼科,272100 [2]哈尔滨医科大学附属第一医院眼科

出　　处：《山东医大基础医学院学报》2000年第2期78-80,共3页

摘　　要：研究疗效好、易掌握、适宜治疗下斜肌功能过强 (IOOA)病例的简便术式并全面评价其疗效。方法 :依次将 IOOA1 +～≥ 4+ 1 62只眼下斜肌附着点前缘移位于巩膜表面 Fink点、直肌中间点、Elliott点及 Elliott前点。 1 1 9例、1 62只眼随访均≥ 1年 ,平均为 4年 1 0个月。结果 :治愈和好转各 55例 ,总有效率为 9 2 .4%。2 1 .1 %的单侧手术眼发生假性 Brown综合征并呈相关表现 ,且与上斜视过矫关系密切。粘连综合征及术眼睑裂变小各 2例。一侧移位术后表现双侧隐蔽性上斜肌麻痹 (BMSOP) 1 3例 ,术后 1年疗效趋于稳定。结论 :此手术适用于治疗 IOOA病例。单眼手术者要倾向保守且要注意 BMSOP的存在。Objective:To search for an effective and simple procedure which can be easily mastered and suits to treat inferior oblique overaction (IOOA) and to evaluate the late result and the complications thoroughly.Methods:For IOOA +～2 +,inferior obliques were reattached to the Fink′s point of 8mm recession;for2 +～3 +,to the point of half way between the temporal border of the insertion of the inferior rectus and the inferior border of the insertion of the lateral rectus (rectus middle point);for3 +～4 +,to the Elliott′s point;for ≥4 +,to the point anterior 2mm to the Elliott′s point and the numbers of those 4 kinds of transposition procedures were 25,44,84 and 9 eyes in their given order.The mean follow up was 58 months with a range from 12 to 129 months in all 119 cases.Results:The cure and improvement rate both were 46.2%.21.1%unilatral operated eyes had pseudo Brown′s syndrome and the manifestations relative to it,which had direct bearing on the overcorrection of hypertropia.Two patients occurred adherence syndrome.Two operated eyes had narrowing palpebral fissures.Thirteen patients showed the symptoms and signs of bilateral masked superior oblique palsy (BMSOP) after unilateral transposition procedures.The results were stable during the postoperative 1 year.Conclusion:The procedure for eliminating IOOA is definite and is suitable for treating all cases with IOOA.It is suggested that one should transfer the unilateral inferior oblique moderately and should always be aware of the existence of BMSOP when managing a patient with unilateral IOOA.

关 键 词：斜视 下斜肌功能过强 下斜肌减弱术 外科手术 

分 类 号：R777.41[医药卫生—眼科]