眼球后退综合征的手术治疗  

The surgical management of Duane retraction syndrome

作　　者：徐佩[1] 邱良秀[1] 王平[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430030

出　　处：《中国斜视与小儿眼科杂志》2012年第4期167-168,I0003,I0004,160,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的探讨并分析Duane眼球后退综合征的手术方法和疗效。方法对我院2004至2011年14例眼球后退综合征合并斜视患者的的临床特点、手术方式和效果进行回顾性总结和分析。9例患者为Duane征Ⅰ型合并内斜视,5例患者为Ⅱ型合并外斜视。内转时同时伴有眼球上/下转现象者10例,有明显代偿头位者4例。根据斜视类型,斜视度数以及内转时是否伴有眼球上/下转现象选择内外直肌后徙或加下斜肌减弱术。以术后斜视度≤±10△为正位。结果 12例患者术后眼位正位,斜视度≤±10△,占总数86%。所有患者术后眼球后退及睑裂变小体征均得到改善。6例患者眼球的上/下转现象消失,4例改善。4例有明显代偿头位患者术后头位消失。结论 Duane眼球后退综合征的手术治疗方法与常规斜视手术不同,其斜视度与手术量无明显对应关系,原则上不主张在患眼行加强术,当眼球内转时伴有明显上转或下转现象时可行内外直肌同时后徙术,必要时可考虑下斜肌手术。术前牵拉试验及术中彻底消除牵制因素是手术成功的关键。Objective To investigate and explore the clinical profile and efficacy of surgery for Duane＇ s Retraction Syndrome（DRS）. Methods A retrospective review was conducted of 14 medical records of patients with Duane＇ s retraction syndrome. 9 cases were DRS type I with esotropia, and 5 cases were DRS type 11 with exotropia. 10 cases had upshoot and/or downshoot phenomenon. 4 cases had the abnormal head posture. According to the degree of deviation and upshoot and/or downshoot of the globe,patients underwent recession of the medial or/and lateral recti, or combining with weakening the inferior oblique muscle simultaneously in some cases. A successful surgical alignment was defined as within ＋ 10zx. Results 12 of the 14 cases （ 86% ） were achieved a successful surgical alignment after surgery. The narrowing of the palpebral fissure with retraction of globe were improved in all cases. The upshoot and/or downshoot of the globe disappeared in 6 cases and had a marked decrease in 4 cases. The abnormal head posture were eliminated in all 4 cases. Conclusions The surgical management of DRS was different from the conventional strabismus. The recession of the recti had no significant corelation with the degree of the deviation. Strengthening the affected eye was not recommended. When the retraction globe had obvious upshoot and/or downshoot phenomenon, recessing both of medial and lateral recti were accomplished. With severe upshoot or downshoot, weakening the inferior oblique muscle was performed simultaneously. Also forcing duction test in preoperation and relieving mechanicalfactors during the operation played an important role in successful surgical results.

关 键 词：DUANE眼球后退综合征 斜视 

分 类 号：R779.6[医药卫生—眼科]