单眼内直肌超常量后徙术在矫正成人小角度内斜视中的手术疗效  

Surgical outcome of extra-large recession of unilateral medial rectus for small angle esotropia in adults

作　　者：曹贺 罗小玲 

机构地区：[1]中国广东省深圳市人民医院眼科,518020

出　　处：《国际眼科杂志》2017年第12期2370-2372,共3页International Eye Science

摘　　要：目的:观察单眼内直肌超常量后徙术在矫正小角度(≤+30~△)非调节性的成人共同性内斜视中的临床效果。方法:回顾分析小角度成人(年龄≥18岁)共同性内斜视患者20例30眼,男女不限,随机分组,按照手术方式分为观察组(单眼内直肌超常量后徙组)和对照组(双眼内直肌等量后徙组)。两组案例全部采用可调节缝线,评估术后3d,3mo的眼位,眼球内转功能及调节性集合与调节的比率(AC/A)。结果:共纳入研究患者20例30眼,男女比例为13∶7,年龄18~42(28.2±19.9)岁,观察组10例10眼,单眼内直肌后徙量在8~9mm;对照组10例20眼,双眼内直肌后徙量在4~5mm。术后3d观察组眼位-3~△^+10~△,平均+5.02~△±2.39~△;对照组眼位-2~△^+10~△,平均+4.86~△±2.28~△,两组比较差异有统计学意义(t=4.36,P<0.05)。术后3mo观察组眼位+4~△^+11~△,平均+4.31~△±1.65~△;对照组眼位+3~△^+10~△,平均+3.91~△±2.68~△,两组比较差异无统计学意义(t=2.01,P>0.05)。术后3d观察组有3眼内转功能受限,对照组无内转功能受限。术后3mo,两组均未出现内转功能受限。同视机法测定术后3mo观察组AC/A为3.09±0.15,对照组AC/A为3.16±0.09,两组比较差异无统计学意义结论:单眼内直肌后徙量在9mm以内是一种安全有效的矫正成人小角度内斜视的手术方式,对眼球内转功能无明显影响。AIM： To evaluate the surgical outcomes of adults who underwent extra-large recession of unilateral medial rectus（UMR）for the treatment of concomitant esotropia less than ＋30 prism diopter（PD）. METHODS： The medical records of 20 patients（30 eyes）who underwent surgical correction of concomitant esotropia less than ＋30 PD were retrospectively reviewed. Patients with esotropia who were previously treated with one or two surgical procedures of adjustable suture（10 eyes as observation group with extra-large recession of UMR as 8-9mm, 10 eyes as control group with bilateral MR recession as 4-5mm）were included in the study. The binocular alignment and adduction function were evaluated at postoperative 3d and 3mo.RESULTS： The male-female rate of the patients was 13：7. The mean age at surgery was 28.2±19.9 years old（range： 18-42 years old）. At 3d after operation, the eye position of the observation group was -3△ to ＋10△（＋5.02△±2.39△）. That of the control group was -2△ to ＋10△（＋4.86△±2.28△）. The difference between the two groups was significant（t=4.36,P〈0.05）. At 3mo after operation, the eye position of the observation group was ＋4△ to ＋11△（＋4.31△±1.65△）. That of the control group was ＋3△ to ＋10△（＋3.91△±2.68△）. The difference between the two groups was not significant（t=2.01,P〉0.05）. There was no statistic difference in the postoperative AC/A between two groups（3.09±0.15 vs 3.16±0.09; t=2.18, P〉0.05 ）in postoperative 3mo. Three eyes of the observation group had adduction limitation in postoperative 3d, while none of patients in control group had this. None in the two groups showed the limitation in postoperative 3mo.CONCLUSION： The surgical correction with UMR recession less than 9mm is safe in small angle esotropia adults, without adduction limitation.

关 键 词：单侧 内直肌后徙 超常量 内斜视 成人 

分 类 号：R779.6[医药卫生—眼科]