先天性上斜肌麻痹下斜肌减弱术后二次手术探查分析  

Analysis of the exploration results of secondary surgery after inferior oblique weaken surgery in patients with congenital superior oblique palsy

作　　者：李桂萍 夏改秀 Gui-ping;Xia Gai-xiu(Department of Ophthalmology,Liaocheng Hospital,Dongchangfuqu Maternal and Child Hospital of Liaocheng,Liaocheng 252000,China)

机构地区：[1]聊城市眼科医院东昌府区妇幼保健院,252000

出　　处：《中国斜视与小儿眼科杂志》2024年第1期14-15,4,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的 探讨先天性SOP患者下斜肌二次手术的原因及治疗效果.方法 回顾性研究.11例SOP首次行下斜肌减弱术,术后仍欠矫、残留头位,进行IO二次手术探查,根据术中探查结果进行分析,并对手术后的眼球转动、垂直眼位和代偿头位进行对比.结果 11例患者4眼发现已切断的IO两端瘢痕连接.曾行IO前转位的1眼术中发现IO于Tenon囊等组织包裹在一起,限制了眼球转动;6眼IO断端纤维附着于眼球颞下方巩膜上.术后随访观察3月,患者垂直斜度、代偿头位、IO亢进情况均得到改善.结论 SOP患者行IO减弱术后,如仍伴有IO亢进表现,通过IO探查,可以找到病因并针对性治疗,可以取得较好的效果.Objective To explore the reason and treatment effect of the secondary operation of inferior oblique(IO)in patients with congenital superior oblique palsy(SOP).Methods retrospective study.11l cases with SOP received IO weakening surgery,but they still retain recurrence head posture.The exploration was analyzed according to the intraoperative exploration results of eye movement,vertical eye position and compensatory head posture.Results Exploratory surgery showed that the scar connection of the severed IO in 4 eyes,broken ends of IO entwined with Tenon Capsulein in 1 eye,severed end fibers of IO oblique muscle bundles were attached to the inferior temporal scleral membrane in 6 eyes.Afer 3 months follow-up,vertical deviation,compensatory head posture and inferior oblique overaction was improved.Conclusions Patients with SOP after IO weakening surgery,if it is stllaccompanied by postoperative inferior oblique overaction,through IO exploration,can be found out the result and targeted treatment,can achieve better results.

关 键 词：上斜肌麻痹 下斜肌减弱 下斜肌探查 

分 类 号：R779.6[医药卫生—眼科]