Ameri Ahmad, Anvari Faramarz, Jafari Alireza K, Ahadzadeghan Iraj, Akbari Mohammad Reza, Rajabi Mohammad Taher
Department of Ophthalmology, School of Medicine, Medical Sciences, Tehran University, Tehran, Iran.
J Pediatr Ophthalmol Strabismus. 2009 Nov-Dec;46(6):368-71. doi: 10.3928/01913913-20091104-10. Epub 2009 Nov 18.
This study evaluated the surgical results of intraoperative adjustable tucking of the anterior portion of the superior oblique tendon for treatment of excyclotorsion. Two cases of acquired bilateral superior oblique palsy with symptomatic excyclotorsion and minimal vertical deviation in primary position were considered. Tucking of the anterior one-third of the superior oblique tendon was performed with a nonabsorbable suture. The amount of tuck was adjusted until the fovea was at the level of the superior one-third of the disc through indirect ophthalmoscopy. In the patient with local anesthesia, a double Maddox rod test was used to evaluate subjective cyclotorsion intraoperatively. After surgery, the patients became symptom-free. No regression toward excyclotorsion was noted during 18 months of follow-up. Tucking of the anterior portion of the superior oblique tendon is an effective procedure for improving symptomatic excyclotorsion in patients with bilateral superior oblique palsy without significant vertical deviation in primary position.
本研究评估了上斜肌腱前部术中可调节折叠术治疗外旋转斜视的手术效果。研究纳入了2例获得性双侧上斜肌麻痹患者，这些患者在原在位时有症状性外旋转斜视且垂直偏斜最小。使用不可吸收缝线对上斜肌腱前三分之一进行折叠。通过间接检眼镜调整折叠量，直到黄斑位于视盘上三分之一水平。对于局部麻醉的患者，术中使用双马多克斯杆试验评估主观旋转斜视。术后患者症状消失。随访18个月期间未发现外旋转斜视复发。上斜肌腱前部折叠术是改善双侧上斜肌麻痹且原在位无明显垂直偏斜患者症状性外旋转斜视的有效方法。
