Wu He-ping, Mai Guang-huan, Deng Da-ming, Lin Xiao-ming, Yu Xin-ping, Chen Jing-chang
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Zhonghua Yan Ke Za Zhi. 2006 Oct;42(10):883-7.
To investigate the effect of weakening the superior oblique muscles on the status of ocular torsion.
Twenty-nine patients (58 eyes) underwent tenotomy or partial ectomy of bilateral superior oblique muscles for treatment of superior oblique overacting. Objective cyclodeviations were assessed by fundus photograph before and 7 days after the surgery. The photographs were transferred to a computer and then the fovea-disc angle was measured by a software for drawing pictures. Subjective cyclodeviations and binocular vision function were assessed by synoptophore.
Fundus photography before surgery revealed that the intorsion was 10.48 degrees +/- 6.01 degrees for the right eye and was 9.37 degrees +/- 5.88 degrees for the left eye. The reduction of the cyclodeviations by weakening the superior oblique muscle for the right and left eye was 9.11 degrees +/- 7.09 degrees and 7.94 degrees +/- 4.76 degrees respectively. The comparisons of objective ocular torsion for both eyes showed high significant differences (P < 0.01) pre- and post-operatively. There were no significant differences (P > 0.05) between the effects of tenotomy or partial ectomy of bilateral superior oblique muscles. All patients showed no cyclotropia and normal binocular vision function was obtained with synoptophore before and after surgery.
Weakening the overaction superior oblique could correct ocular incyclodeviation. Both tenotomy and partial ectomy of bilateral superior oblique muscles can treat ocular incyclodeviation effectively. The changes of subjective and objective cyclodeviations are inconsistent with each other.
探讨减弱上斜肌对眼扭转状态的影响。
29例患者（58只眼）因上斜肌亢进接受双侧上斜肌断腱术或部分切除术。术前及术后7天通过眼底照相评估客观眼旋转偏斜。将照片传输至计算机，然后使用绘图软件测量黄斑-视盘夹角。通过同视机评估主观眼旋转偏斜和双眼视功能。
术前眼底照相显示，右眼内旋为10.48°±6.01°，左眼内旋为9.37°±5.88°。右眼和左眼通过减弱上斜肌导致的眼旋转偏斜减少分别为9.11°±7.09°和7.94°±4.76°。双眼客观眼扭转术前与术后比较差异有高度统计学意义（P<0.01）。双侧上斜肌断腱术或部分切除术的效果之间差异无统计学意义（P>0.05）。所有患者均无旋转斜视，术前及术后同视机检查均获得正常双眼视功能。
减弱亢进的上斜肌可矫正眼内旋转偏斜。双侧上斜肌断腱术和部分切除术均可有效治疗眼内旋转偏斜。主观和客观眼旋转偏斜的变化相互不一致。
