Ohba Masahiro, Ohtsuka Kenji, Osanai Hajime
Department of Ophthalmology, Sapporo Medical University School of Medicine, S-1 W-16, Chuo-ku, Sapporo 060-8543, Japan.
Binocul Vis Strabismus Q. 2004;19(1):13-20.
To evaluate the therapeutic effects of surgically slanting extraocular muscle insertions.
Observational case series.
We performed slanting recession and resection on medial or lateral rectus muscles. We created a slanting surgical reinsertion line with a 3-4 mm difference between upper and lower corners of the muscles, in 31 patients with A or V strabismus (V exotropia in 16 patients; A exotropia in 12; A esotropia in 3). Cases with V exotropia with moderate or marked overaction of inferior oblique muscle were excluded.
V exotropia: The average amount of V pattern was 17.9 PD before and 7.6 PD after surgery. Slanting surgery reduced the V pattern in 15 of 16 patients. The mean amount of reduction was 10.3 PD in the V pattern and 29.8 PD in upgaze. A exotropia: The average amount of the A pattern was 26.6 PD before and 6.3 PD after surgery. Slanting surgery reduced the A pattern in 8 of 12 patients. The mean reduction was 20.3 PD in the A pattern and 36.4 PD in downgaze. A esotropia: The average amount of the A pattern was 23 PD before and 8 PD after surgery, reducing the A pattern in 1 of 3 patients.
The surgical technique of slanting muscle insertions for correction of A and V strabismus is a suitable procedure for reducing or eliminating A and V patterns.
评估手术倾斜眼外肌附着点的治疗效果。
观察性病例系列。
我们对内直肌或外直肌进行倾斜后徙和切除。我们为31例A或V型斜视患者（16例V型外斜视；12例A 型外斜视；3例A 型内斜视）创建了一条倾斜的手术重新附着线，肌肉上下角之间相差3 - 4毫米。排除伴有下斜肌中度或明显亢进的V型外斜视病例。
V型外斜视：手术前V型斜视平均度数为17.9三棱镜度，手术后为7.6三棱镜度。倾斜手术使16例患者中的15例V型斜视度数降低。V型斜视平均降低度数为10.3三棱镜度，上注视时降低29.8三棱镜度。A 型外斜视：手术前A 型斜视平均度数为26.6三棱镜度，手术后为6.3三棱镜度。倾斜手术使12例患者中的8例A 型斜视度数降低。A 型斜视平均降低度数为20.3三棱镜度，下注视时降低36.4三棱镜度。A 型内斜视：手术前A 型斜视平均度数为23三棱镜度，手术后为8三棱镜度，3例患者中有1例A 型斜视度数降低。
用于矫正A和V型斜视的肌肉附着点倾斜手术技术是减少或消除A和V型斜视的合适方法。
