继发性外斜视的发病因素及手术治疗  

The causes and surgical treatment of consecutive exotropia

作　　者：封利霞[1] 赵堪兴[1] 郭新[1] 宋坤英[1] 

机构地区：[1]天津眼科医院,300040

出　　处：《眼科研究》2003年第1期65-67,共3页Chinese Ophthalmic Research

摘　　要：目的 探讨继发性外斜视的发病因素及手术治疗。 方法 对近5年行二次手术的23例继发性外斜视进行回顾分析。 结果23例患者中弱视占43.5％,高度近视占26.1％,无双眼视功能者占82.6％,运动受限者占 56.5％,伴AV征、DVD、眼球震颤、垂直斜视共占73.9％。行单眼或双眼内直肌复位或缩短后复位或联合对侧外直肌退后术后,19例获得正位或水平斜度<10△,垂直斜度<5△。手术成功率82.6％。 结论 继发性外斜视的发病因素包括不正确的手术方式及手术量,弱视,高度远视,无双眼视功能,伴有其他眼肌不平衡。根据肌肉功能状态、视力、原手术量和远近斜视度设计手术方案可取得良好矫正效果。Objective To investigate the causes and optimal surgical treatment of consecutive exotropia. Method Twenty-three cases with consecutive exotropia were analyzed retrospectively. Results Ten of 23 patients had amhlyopia (43. 5% ) ,6 patients showed high hyperopia( 26. 1% ) ,19 patients had no binocular function(82. 6% ) ,13 patients had adduct limitation (56. 5% ) and the patients accompanied with A or V patterns , DVD , nystagmus or vertical deviation added up to 17(73. 9% ). After unilateral or bilateral advancement of the medial rectus muscle to the original muscle insertion accompanied with or without recession of contralaleral rectus muscle, 19 cases had satisfactory alignment within 10 for horizontal and less than 5 for vertical deviations both at distance and at near fixation. Conclusion The causes of consecutive exotropia include incorrect surgery ,amblyopia, high hyperopia, without binocular function, accompanied with other kinds of strabismus. Good results can be obtained following reasonable surgery design according to the function state of ocular muscles, vision acuity, previous surgery and the deviations at distance and near.

关 键 词：继发性外斜视 发病因素 手术治疗 原发性内斜视 

分 类 号：R779.6[医药卫生—眼科]