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[摘要]
目的:通过不同量的下斜肌转位术对双眼不对称的分离性垂直斜视(DVD)的治疗,观察眼位矫正效果和并发症情况。
方法:选择双眼垂直斜度不相等的DVD患者15例,均伴有下斜肌功能亢进+~+++,上斜度为15△~20△眼采取下斜肌部分转位术,上斜度>20△眼采取下斜肌全部转位术。术后观察眼位矫正情况及睑裂变化、眼球运动情况。
结果:术后双眼第一眼位上斜明显改善,下斜肌功能亢进均消失,双眼睑裂大小基本对称,向上注视时上转程度相等。
结论:DVD患者双眼上斜程度往往不对称,可根据第一眼位垂直斜度大小分别采取下斜肌全部转位和部分转位,以减少术后双眼睑裂不等大或上转程度不相等的并发症。
[Key word]
[Abstract]
AIM: To evaluate the efficacy of anterior transposition of the inferior oblique muscle(IO)for treatment of eyes with asymmetric double dissociated vertical deviation(DVD).
METHODS: Totally 15 patients with asymmetric DVD which coexisted with unequal IO overaction(IOOA)(+~+++)were enrolled, the eye of strabismus degree >15△-20△ underwent anterior transposition of the part muscles inferior oblique muscles, and the eye of strabismus degree>20△ underwent anterior transposition of the all muscles inferior oblique muscles, the correct intensity of eye position and muscle function after surgery and the size of palpebral fissure were evaluated.
RESULTS: The IOOA disappeared in all of 15 eyes, and according to the data of the postoperative effect which was good in 13 cases and there still was residued degree vertical slope in 2 cases, in other respects, a little limited of eye ball up rotation and coarctation of palpebral fissure were observed.
CONCLUSION: The slope degree of DVD is often asymmetric, and it could treat with all inferior oblique translocation or translocation respectively, according to the first bit vertical gradient size, in order to reduce coarctation of palpebral fissure or on limited of eye ball up rotation.
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