双上转肌麻痹Knapp手术的疗效观察  

Observation on the efficacy of Knapp procedure for the treatment of double elevator palsy

作　　者：左绪宏[1] 卓旭英[1] 马路生[1] 高磊[1] Zuo Xuhong Zhuo Xuying Ma Lusheng Gao Lei(Department of Ophthalmology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, Shandong 264000, Chin)

机构地区：[1]青岛大学附属烟台毓璜顶医院眼科,山东烟台264000

出　　处：《中华眼外伤职业眼病杂志》2017年第2期118-121,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价Knapp手术（水平直肌垂直移位术）治疗双上转肌麻痹的临床效果。方法回顾性分析Knapp手术治疗双上转肌麻痹6例（6眼）的临床效果。结果术后，6例眼球运动上转功能均较术前明显改善，4例单眼上转可过中线15°，2例过中线5°-10°，无下转功能受限发生。6例术前垂直斜视度20～45PD，平均为（29．2±9．7）PD，经过12—24月随诊，4例术后残余垂直斜视度在5PD以内，无1例过矫，Knapp手术解决的平均斜视度为（24．5±7．1）PD。术后1个月内及随诊12个月以上的斜视度分别为（11．7±6．1）PD和（4．7±2．9）PD，差异具有统计学意义（P〈0．05），平均漂移度为（7．0±5．4）PD。结论Knapp手术是治疗双上转肌麻痹致下斜视的有效方法，该术式随着时间推移上转作用增强。Objective To evaluate the efficacy of Knapp procedure （full tendon width vertical transposition of horizontal recti ） for the treatment of double elevator palsy （DEP）. Methods A retrospective study was taken to analyze the efficacy of the Knapp procedure and the postoperative stability of alignment on the magnitude of correction. Six eyes of six patients with DEP underwent Knapp procedure. Results Postoperatively, the function of eyeball upward movement was improved in 6 eyes. Ocular motility was elevated over midline 15° in 4 eyes and over the midline within 5°-10° in 2 eyes. No case had been limited in downgaze. The preoperative average vertical deviation was （29.2 ± 9.7） PD （ prism diopter） （range 20-45 PD）. Four eyes were corrected within 5 PD of orthophoria and no one was found with overcorrection over 12-24 months follow-up. The average vertical correction of Knapp procedure was （24.5 ± 7.1 ） PD. The mean postoperative deviation in 1 month and over 12 months were （ 11.7 ± 6. 1 ） PD and （4.7 ± 2.9 ） PD respectively （ P 〈 0.05 ）. The average magnitude of drift was （7.0 ± 5.4 ） PD. Conclusion The Knapp procedure can effectively correct the hypotropia in patients with DEP and it has an increased effect over time.

关 键 词：双上转肌麻痹 下斜视 Knapp手术 

分 类 号：R779.6[医药卫生—眼科]