上斜肌后徙术对眼球旋转状态的影响  

The effect of superior oblique recession on the status of ocular torsion

作　　者：刘明美[1] 赵敬聪[2] 张伟[1] 

机构地区：[1]天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所天津医科大学眼科临床学院,300020 [2]河北省儿童医院

出　　处：《中华眼科杂志》2014年第7期500-503,共4页Chinese Journal of Ophthalmology

摘　　要：目的 探讨上斜肌后徙术对上斜肌功能亢进引起的内旋转斜视的疗效.方法 回顾性研究.对20例（31只眼）上斜肌功能亢进的患者行上斜肌后徙术,其中双眼11例,单眼9例.于术前和术后1、30、90 d行双眼眼底照相检查,使用绘图软件测量黄斑与视乳头的夹角,记录眼球的客观旋转角度.使用双马氏杆和同视机检查主观旋转角度,同时行Bagolini线状镜和Titmus立体视觉检查图了解双眼视功能.对手术前后眼球旋转度数组间及两两比较分别采用配对t检验和单因素方差分析,对术前客观旋转度数及上斜肌亢进程度与术后内旋转度数减少量的相关性采用直线相关分析.结果 11例双眼患者术前右眼为内旋转9.50°±5.13°,左眼为8.23°±3.45°,双眼间差异无统计学意义（t=l.12,P=0.29）.9例单眼手术患者术前患眼为内旋6.55°±4.14°,对侧眼为6.85°±5.08°,双眼间差异无统计学意义（t=0.13,P=0.90）.11例双眼手术患者术前总内旋度数为17.74°±7.89°,术后1、30、90d总内旋转度数分别为7.63°±4.28°、6.05°±6.11°、7.33°±6.17°,组间比较差异有统计学意义（F=8.245,P＜0.01）.9例单眼手术患者术前双眼总内旋度数为13.40°±6.13°,术后1、30、90d总内旋转度数分别为5.06°±3.99°、3.59°±3.47°、5.07°±3.35°,组间比较差异有统计学意义（F=9.351,P＜0.01）.4例存在主观旋转感觉的患者手术前后主观旋转度数与客观不一致.8例患者术后双眼视功能较术前改善.结论 上斜肌后徙术可有效矫正由于上斜肌功能亢进而引起的内旋转斜视.Objective To investigate the effect of superior oblique recession on the status of ocular torsion.Methods Twenty patients （31 eyes） underwent superior oblique recession for treatment of superior oblique overacting,11 cases had both eyes involvement while 9 had monocular.Objective cyclotorsion were examined pre-operation,as well as 1,30,90 days post-operation with fundus photograph.The photographs were transferred to a computer and then the fovea-disa angle （FDA） was measured by a software for drawing pictures.Subjective cyclotorsion were assessed by double Maddox rod test and synoptophore,while the binocular vision function by Bagolini glasses and Titmus.Results For 11 cases of the both eyes involvement,preoperation FDA was 9.50° ±5.12°in the right eyes,8.23° ± 3.45° in the left eyes,there was not statistically significant between two eyes （t =1.12,P =0.29）.For 9 cases of the monocular eye involvement,preoperation FDA was 6.55° ±4.14°in the affected eyes,6.85° ±5.08° in the follow eyes,there was also not statistically significant between two eyes （t =0.13,P =0.90）.To 1 1 cases of the both eyes involvement,the combined FDA of preoperation and 1,30,90 days after operation were 17.74° ±7.89°and 7.63 ° ± 4.28 °,6.05 ° ± 6.1 1 °,7.33 ° ± 6.17 ° respectively.The comparision of objective ocular cyclotorsion for both eyes showed significant difference pre-and post-operation（F =8.245,P 〈0.01）.To 9 cases of the monocular eye involvement,the combined FDA of preoperation and 1,30,90 days after operation were 13.40° ±6.13°and 5.06° ±3.99°,3.59° ± 3.47°,5.07° ± 3.35°respectively.The comparision of objective ocular cyclotorsion showed significant difference pre-and post-operation （F =9.351,P 〈 0.01）.Four patients had subjective cyclotorsion,but it＇s different with objective cyclotorsion before and after surgery.8 patients＇ binocular vision function were ameliorated after surgery.Conclusion Recession of overaction superior oblique muscles can correct ocular incy

关 键 词：斜视 动眼肌 眼球运动障碍 眼外科手术 

分 类 号：R779.6[医药卫生—眼科]