Vodicková K, Autrata R, Rehůrek J
D4ĕtská ocní klinika LF MU a FN, Brno.
Cesk Slov Oftalmol. 2008 Jul;64(4):157-60.
Anterior transposition of the inferior oblique muscle (ATIO) and myectomy of the inferior oblique muscle (MIO) are favorite methods for surgical correction of dissociated vertical deviation (DVD), including patients with simultaneous inferior oblique muscle overaction (IOOA). In our comparative, randomized study we evaluated whether anterior transposition improves the surgical outcome compared to myectomy of the inferior oblique muscle. We included 82 eyes of 46 patients, 44 eyes treated with ATIO and 38 treated with MIO. We observed the size of the preoperative and final DVD, grade of the preoperative and final IOOA, rates of reoperation, and complications. We found out that ATIO is an effective surgical approach in the treatment of DVD and it can be used in patients with or without IOOA. We found no statistically significant difference in postoperative outcomes between anterior transposition and myectomy of the inferior oblique muscle. Despite of it, we prefer unilateral ATIO to manage IOOA for its minor incidence of secondary hyperfunction of contralateral inferior oblique muscle.
下斜肌前徙术(ATIO)和下斜肌切除术(MIO)是用于手术矫正分离性垂直偏斜(DVD)的常用方法,包括同时存在下斜肌亢进(IOOA)的患者。在我们的对比随机研究中,我们评估了与下斜肌切除术相比,下斜肌前徙术是否能改善手术效果。我们纳入了46例患者的82只眼,其中44只眼接受了下斜肌前徙术治疗,38只眼接受了下斜肌切除术治疗。我们观察了术前和最终DVD的大小、术前和最终IOOA的分级、再次手术率和并发症。我们发现下斜肌前徙术是治疗DVD的一种有效手术方法,可用于有或没有IOOA的患者。我们发现下斜肌前徙术和下斜肌切除术之间的术后结果没有统计学上的显著差异。尽管如此,我们更倾向于采用单侧下斜肌前徙术来治疗IOOA,因为其对侧下斜肌继发性功能亢进的发生率较低。