下斜肌转位术对间歇性外斜视手术的影响  

The effect of inferior oblique muscle transposition on intermittent exotropia

作　　者：夏韦艺 赵晨 Xia Wei-yi;Zhao Chen(Hospital of Kun- shan,affiliated with Jiangsu University,Suzhou,215300 China.)

机构地区：[1]江苏大学附属昆山医院,苏州市215300

出　　处：《中国斜视与小儿眼科杂志》2018年第2期20-23,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的探讨外直肌后徙术联合下斜肌转位术治疗间歇性外斜视的疗效及下斜肌转位术后对水平斜视度的影响。方法回顾外直肌后徙术联合或不联合下斜肌转位术治疗的间歇性外斜视132例。根据是否行下斜肌转位术分为A组外直肌后徙术联合下斜肌转位术31例;B组单纯外直肌后徙术101例。对患者末次回访时情况进行回顾性分析,比较A、B两组患者的手术效果。以美国眼科学会推荐的外直肌后徙量作为患者预计矫正斜视度(对照组),比较A组术后视近(33cm)和视远(5m)处的斜视度数变化量与对照组的差异,分析下斜肌转位术对水平斜视度数的影响。结果 A组正位23例、欠矫8例、过矫0例;B组正位78例、欠矫23例、过矫0例(χ~2=0.12,P=0.73)。A组31例患者中,23例行单眼下斜肌转位术患者较对照组视近、视远分别多矫正1.5±4.3PD(P=0.48)和-1.0±3.2PD(P=0.52)。8例行双眼下斜肌转位术患者较对照组视近和视远分别多矫正1.1±4.8PD(P=0.58)和0.6±8.3PD(P=0.97)。结论下斜肌转位术对治疗间歇性外斜视合并下斜肌功能亢进效果良好;外直肌后徙术联合下斜肌转位术治疗外斜视时,可不考虑下斜肌转位术对水平斜视度数的影响。Objective To evaluate the effect of anterior transposition of inferior oblique muscle combined with rectus muscle recession procedure for intermittent exotropia.To quantity the efficacy of anterior transposition of inferior oblique muscle for horizontal deviations.Methods Cases who underwent a simultaneous procedure of lateral rectus muscle recession as well as anterior transposition of inferior oblique muscle were categorized as group A（31cases） and those who underwent lateral rectus muscle recession as a sole operation were categorized as group B（101cases）.Surgical outcomes among the two groups were evaluated and compared.Guidelines of the American Academy of Ophthalmology（AAO） were applied for surgical amounts of exotropia and set as control group.The corrected horizontal amounts at near and distance in group A were compared with control group.Results When the rate of horizontal orthophoria between group A and group B was compared, no significant difference was identified（P=0.73）.Compared to control group, 23 patients in group A who underwent unilateral anterior transposition of inferior oblique muscle displayed an overcorrection of 1.5±4.3PD（P = 0.48）and-1.0±3.2PD（P= 0.52） at near and distance, respectively.This figure for patients who underwent bilateral operation（n = 8） was 1.1±4.8 PD（P=0.14） at near and 0.6±8.3PD（P = 0.97） at distance.Conclusions Anterior transposition of inferior oblique muscle appears to be a safe and decent procedure for patients of intermittent exotropia with IOOA.The efficacy of anterior transposition of inferior oblique muscle for horizontal deviations is negligible in planning a simultaneous horizontal muscle surgery and setting the surgical amount.

关 键 词：下斜肌转位术 下斜肌功能亢进 间歇性外斜视 

分 类 号：R779.6[医药卫生—眼科]