直肌后固定的微创斜视手术
Minimally invasive strabismus surgery for rectus muscle posterior fixation.
作者信息
Mojon Daniel S
机构信息
Department of Strabismology and Neuro-Ophthalmology, Kantonsspital, St. Gallen, Switzerland.
出版信息
Ophthalmologica. 2009;223(2):111-5. doi: 10.1159/000180279. Epub 2008 Dec 10.
AIMS
To present a novel, minimally invasive strabismus surgery (MISS) technique for rectus muscle posterior fixation.
METHODS
This study reports the results of 32 consecutive MISS rectus muscle posterior fixation surgeries performed on 19 patients by applying only two small L-shaped openings where the two retroequatorial scleromuscular sutures were placed.
RESULTS
On the first postoperative day, in primary position, redness was hardly visible in 16 eyes (50%) and only moderate redness was visible in 6 eyes (19%). No serious complication occurred. Preoperative visual acuity and refraction remained unchanged at 6 months (p > 0.1). The preoperative convergence excess (n = 13) decreased from 10.3 +/- 4.1 to 5.2 +/- 4.0 degrees at 6 months (p < 0.005). In all patients operated on for gaze incomitance (n = 6) improvement was achieved at 6 months.
CONCLUSIONS
This study shows that keyhole minimal-dissection rectus muscle posterior fixation surgery is feasible and effective to improve ocular alignment. The MISS technique seems to be superior in the direct postoperative period since only minimal conjunctival swelling and no corneal complications were observed.
目的
介绍一种用于直肌后固定的新型微创斜视手术（MISS）技术。
方法
本研究报告了对19例患者连续进行32例MISS直肌后固定手术的结果，手术仅通过两个小L形切口放置两条赤道后巩膜肌缝线。
结果
术后第一天，在第一眼位时，16只眼（50%）几乎看不到充血，6只眼（19%）仅可见中度充血。未发生严重并发症。术前视力和屈光度在6个月时保持不变（p>0.1）。术前集合过强（n=13）在6个月时从10.3±4.1度降至5.2±4.0度（p<0.005）。所有因注视不能而接受手术的患者（n=6）在6个月时均有改善。
结论
本研究表明，锁孔微创直肌后固定手术对于改善眼位是可行且有效的。MISS技术在术后早期似乎更具优势，因为仅观察到最小程度的结膜肿胀且无角膜并发症。
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