单眼超常规量直肌手术矫正共同性内斜视  

Monocular extraordinary amount of surgical correction in Concomitant Esotropia

作　　者：魏艳飞[1] 陈金卯[1] 陈霞琳[1] 黄宜华[1] 

机构地区：[1]广西医科大学第一附属医院眼科,广西壮族自治区南宁市530021

出　　处：《中国实用眼科杂志》2016年第7期763-765,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察单眼水平直肌超常量手术矫正共同性内斜视的术后眼位成功率和眼球运动情况。方法回顾性无对照病例方法。对2009年1月至2014年7月在广西医科大学第一附属医院眼科行单眼超常量眼肌手术的30例资料齐全的不同偏斜度共同性内斜视患者入选。排除非共同性内斜视及既往有眼肌手术病史的患者。共同性内斜视患者30例，含知觉性内斜22例，行主斜眼内直肌后徙6～7mm，或伴有同眼外直肌截短6-9mm。随访时间：1．5～60个月。观察指标：术后不同时期的眼位和眼球运动。末次随访的眼位偏斜度〈10PD视为正位，眼球内转或外转不足-1--14均视为运动异常。结果30例共同性内斜视患者末次随访时双眼正位24例，正位率为80％。30例共同性内斜视患者术前8例存在外转不足（-1--2），大部分存在内转不同程度亢进，术后6周以上随访，29例患者眼球内外转均到位，1例术前外转-2，术后改善为外转-1。结论单眼直肌超常量手术可有效地矫正共同性内斜视；内直肌后徙6～7mm或联合外直肌截短术未导致眼球运动障碍，术前外转不足的患者术后得到改善。Objective To evaluate the success rate and motor outcomes of monocular horizontal muscle surgery with extraordinary gauge in patients with concomitant esotropia. Methods Thirty patients with concomitant esotropia with complete date were undertaken surgery with extraordinary amount of operation in Department of Ophthalmology for the First Affiliated Hospital of Guangxi Medical University between January 2009 and July 2014. Strabismus and a history of previous ocular muscle operation were excluded. The 30 cases of patients with concomitant internal strabismus, including 22 cases of sensory esotropia who underwent unilateral medial rectus muscle recession in 6-7mm, or/with the lateral rectus muscle resection in 6-9mm in the deviated eye ball. The follow-up time ranged 1.5 to 60 months. The residual deviation and duction were observed in different periods. The residual deviation below 10 PD was successful. Duction defects of-1 --4 were regarded as motion abnormality. Results Twenty-four of 30 patients were achieved good appearance （80%）. Eight patients with concomitant esotropia had abduction defects of -1--2 before operation. A majority of patients had tumed in hyperthyroidism before operation. Only 1 patient of abduction was changed from -2 to -1 and 29 patients moved normally after surgery. Conclusions Unilateral strabismus surgery can effectively correct the concomitant squints. 6-7ram of medical rectus muscle recession has nothing to do with eyeball movement.

关 键 词：共同性内斜视 水平直肌超常量 眼位 眼球运动 

分 类 号：R777.41[医药卫生—眼科]