Hong Samin, Chang Yoon-Hee, Han Sueng-Han, Lee Jong Bok
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Dokok-dong 146-92, Kangnam-Gu, Seoul 135-270, Korea.
Am J Ophthalmol. 2005 Sep;140(3):477-83. doi: 10.1016/j.ajo.2005.04.028.
To evaluate the results of the full rectus muscle transposition augmented with a posterior intermuscular suture for paralytic strabismus.
Single-center, retrospective, interventional case series.
This study retrospectively reviewed the medical records from November 1994 to September 2004 of 16 patients who underwent the full tendon transposition that was augmented with posterior intermuscular suture for paralytic strabismus. This series evaluated the results of a single transposition surgery; five patients had previous nontransposition strabismus surgery. The following data were analyzed before and after the operation: (1) the angle of deviation in the primary position, (2) the presence of diplopia in the primary position, (3) the binocular single visual fields, (4) the presence of an abnormal head posture, (5) the motility of the affected eye, and (6) the procedure that was performed.
The preoperative angle of deviation in the primary position was 59 +/- 22 prism diopter (prism diopter; range, 30 to 115 prism diopter) compared with 17 +/- 12 prism diopter (range, -10 to 40 prism diopter) after the operation. The preoperative binocular single visual fields improved from 0 degrees to 60 +/- 25 degrees (range, 0 to 90 degrees) after the operation. Diplopia in the primary position was resolved in 11 patients (69%) after the operation. There were no complications such as scleral perforation, unwanted vertical deviations, or anterior segment ischemia in any of the cases during the procedure and postoperative follow-up.
Full tendon transposition that is augmented with a posterior intermuscular suture is an effective procedure that results in improved ocular alignment in patients with paralytic strabismus and has a favorable complication profile.
评估采用肌间后缝线增强的完全直肌转位术治疗麻痹性斜视的效果。
单中心、回顾性、干预性病例系列研究。
本研究回顾性分析了1994年11月至2004年9月期间16例行完全肌腱转位术并采用肌间后缝线增强治疗麻痹性斜视患者的病历。本系列研究评估了单次转位手术的效果；5例患者曾接受过非转位性斜视手术。分析了手术前后的以下数据：（1）原在位的斜视度，（2）原在位复视情况，（3）双眼单视野，（4）异常头位情况，（5）患眼的运动，（6）所施行的手术。
术前原在位斜视度为59±22三棱镜度（三棱镜度；范围为30至115三棱镜度），术后为17±12三棱镜度（范围为-10至40三棱镜度）。术前双眼单视野术后从0度改善至60±25度（范围为0至90度）。术后11例患者（69%）原在位复视消失。术中及术后随访期间，所有病例均未出现巩膜穿孔、不必要的垂直斜视或眼前段缺血等并发症。
采用肌间后缝线增强的完全肌腱转位术是一种有效的手术方法，可改善麻痹性斜视患者的眼位，且并发症较少。
