Singh Vinita, Agrawal Saurabh, Agrawal Siddharth
Department of Ophthalmology, King Georges' Medical University; and L. V. Prasad Eye Institute (Saurabh Agrawal), Hyderabad, Lucknow, India.
J Pediatr Ophthalmol Strabismus. 2009 Nov-Dec;46(6):350-7. doi: 10.3928/01913913-20090818-09. Epub 2009 Nov 18.
The aim of this study was to analyze the outcome of unilateral inferior oblique (IO) recession in patients with unilateral or asymmetrical IO overaction in terms of effectiveness, stability, and undesired effects.
Fifteen patients with nonparalytic strabismus who underwent unilateral IO recession for unilateral or asymmetric IO overaction and horizontal muscle surgery were included in this study. Nine patients demonstrated asymmetric bilateral IO overaction, whereas 6 had unilateral overaction. All patients underwent IO recession to the Scheie Parks point in one eye, along with conventional horizontal muscle surgery. Clinical outcome assessment included changes in oblique muscle dysfunction in both eyes. Changes in horizontal deviation, V pattern, vertical deviation, and excyclotorsion were also studied.
Satisfactory outcome in terms of oblique muscle function, V pattern, vertical deviation, and cyclodeviation was achieved in all patients with unilateral IO overaction and 7 (77%) patients with bilateral IO overaction. Increased IO overaction in the other eye was noted in 2 patients. Satisfactory outcome in patients with bilateral overaction was related to degree of asymmetry in IO overaction between the 2 eyes.
Unilateral IO recession is effective in patients with unilateral IO overaction and selected patients with largely asymmetrical bilateral IO overaction.
本研究旨在从有效性、稳定性和不良反应方面分析单侧下斜肌(IO)后徙术治疗单侧或不对称性IO亢进患者的疗效。
本研究纳入了15例非麻痹性斜视患者,这些患者因单侧或不对称性IO亢进接受了单侧IO后徙术及水平肌手术。9例患者表现为不对称性双侧IO亢进,6例为单侧亢进。所有患者均对一眼的IO进行后徙至谢伊·帕克斯点,并同时进行传统的水平肌手术。临床疗效评估包括双眼斜肌功能障碍的变化。还研究了水平斜视度、V征、垂直斜视度和外旋转斜视的变化。
所有单侧IO亢进患者及7例(77%)双侧IO亢进患者在斜肌功能、V征、垂直斜视度和旋转斜视方面均取得了满意的疗效。2例患者对侧眼IO亢进加重。双侧亢进患者的满意疗效与双眼IO亢进的不对称程度有关。
单侧IO后徙术对单侧IO亢进患者及部分双侧IO亢进且不对称程度较大的患者有效。