单眼直肌超常量手术治疗大角度知觉性外斜视  

Monocular surgery with exceed constant rectus amount for large-angle sensory exotropia

作　　者：黄勇志[1] 孙涛[1] 林旭初[1] 王红[1] 李丽[1] 

机构地区：[1]中国人民解放军第三○三医院眼科,广西壮族自治区南宁市530021

出　　处：《眼科新进展》2015年第12期1159-1162,共4页Recent Advances in Ophthalmology

摘　　要：目的观察单眼直肌超常量手术治疗大角度知觉性外斜视的手术效果。方法回顾性分析2004年1月至2014年1月在我院住院手术的大角度知觉性外斜视（≥50~△）患者45例,根据手术量不同分两组,单眼超常量（内直肌缩短≥6 mm、外直肌后退≥8 mm）手术组（A组,23例）,常量（内直肌缩短〈6 mm、外直肌后退〈8 mm）手术组（B组,22例）,观察术前及术后斜视度、手术量、眼球活动度,手术并发症。眼位≤±10~△为治疗成功。结果两组术前斜视度比较差异无统计学意义（P〉0.05）,手术成功率A组82.61%、B组90.91%,两组手术成功率比较差异无统计学意义（P〉0.05）。单眼手术率A组100.00%、B组9.09%,差异有统计学意义（P〈0.05）。A组术后所有患者在眼前位眼球活动自如,向外侧极限眼位注视均存在外展不足现象。B组眼前位和极限眼位均无眼球活动障碍。结论对于视力极差的大角度知觉性外斜视患者可考虑进行单眼内外直肌超常量手术,治疗安全有效,缺点是术后眼球外展不足。Objective To observe the surgical effects of monocular surgery with exceed constant rectus amount in treating large-angle sensory exotropia.Methods A retrospective analysis of 45 surgical cases with large-angle sensory exotropia（≥50~△） who were treated between January 2004 and January 2014 in our hospital was performed,the patients were divided into two groups according to the surgical dosage,23 cases of monocular exceed constant amount group（group A,medial rectus resection ≥6 mm,lateral rectus recession ≥ 8 mm）,22 cases of constant amount group（group B,medial rectus resection 〈6 mm,lateral rectus recession 〈8 mm）.The preoperative and postoperative strabismus degree,surgical dosage,eye movement and complications were observed.The eye position ≤ ± 10~△ was set as the successful.Results Surgical success rate in group A and group B were 82.61%,90.91%,respectively,the preoperative strabismus degree and surgical success rate between the two groups had no statistical significance（all P〉0.05）.Monocular operation rate in group A and group B were 100.00%,9.09%,respectively,（P〈0.05）.Limitation on abduction in extreme horizontal gaze position was found in all cases of group A,and not found in group B.Conclusion Monocular surgery with exceed constant amount of medial rectus resection and lateral rectus recession in treating large-angle sensory exotropia with very poor vision is safe and effective.The disadvantage is limitation on abduction.

关 键 词：超常量手术 大角度斜视 知觉性外斜视 

分 类 号：R777.410.6[医药卫生—眼科]