Helveston综合征的手术治疗  

Surgical treatment methods for Helveston syndrome

作　　者：王成虎[1] 徐新萌[1] 蒋沁[1] 

机构地区：[1]南京医科大学附属眼科医院,中国江苏省南京市210029

出　　处：《国际眼科杂志》2016年第7期1392-1393,共2页International Eye Science

基　　金：南京医科大学科技发展基金项目(No.2014NJMU067)~~

摘　　要：目的：探讨Helveston综合征的手术治疗方法。方法：回顾分析我院手术治疗且资料完整的15例30眼Helveston综合征病例,根据患者上斜肌亢进及分离性垂直偏斜（dissociated vertical deviation,DVD）程度的不同选择不同的手术方式。结果：患者8例16眼行双眼上斜肌鞘内断腱术,术后随访1-3a,A征均消失,其中3例6眼DVD消失,5例10眼DVD减轻,均未再次行DVD矫正手术;患者4例8眼行双眼上直肌后徙联合双眼外直肌后徙并垂直移位术,术后随访1-3a,眼位正位,A征消失,1例2眼DVD消失,3例6眼DVD减轻,未再行二次手术;患者3例6眼行双眼水平直肌后徙联合垂直移位术,术后随访6mo,眼位正位,A征消失,DVD减轻,未再次行二次手术。结论：Helveston综合征可根据患者上斜肌亢进及DVD程度的不同选择不同的手术方式。AIM： To investigate the surgical methods of Helveston syndrome. METHODS： Fifteen cases （ 30 eyes ） with Helveston syndrome were studied. Surgical method was selected according to the degree of superior oblique muscle overaction and dissociated vertical deviation （DVD）. RESULTS： Binocular superior oblique intrathecal tenectomy was performed in 8 patients （16 eyes）. Follow-up period after surgery was 1-3a. Those 8 patients got A-sign correction, of which 3 patients （6 eyes） got DVD vanished and 5 patients （10 eyes） got DVD alleviation. None of the 8 cases needed another operation for DVD. Binocular superior rectus recession and binocular lateral rectus recession with vertical offsets was performed in 4 patients （8 eyes）. Follow-up period after surgery was 1-3a. The 4 patients got A sign correction and with orthophoria, of which 1 patient （ 2 eyes ） got DVD vanished and 3 patients （ 6 eyes） got DVD alleviation. None of the 4 cases needed another operation for DVD. Binocular lateral rectus recession and vertical offsets was performed in 3 patients （6 eyes）. Follow-up period after surgery was half a year, with orthophoria, no A sign, DVD weakened, and no second operation was needed. CONCLUSION： Surgical procedures for Helveston syndrome can be selected according to the degree of superior oblique muscle overaction and DVD.

关 键 词：HELVESTON综合征 上斜肌 手术 DVD 

分 类 号：R779.6[医药卫生—眼科]