Wright Kenneth W
Wright Foundation for Pediatric Ophthalmology and Strabismus and the Department of Ophthalmology, University of Southern California-Keck School of Medicine, Los Angeles, California, USA.
Trans Am Ophthalmol Soc. 2009 Dec;107:97-102.
The mini-tenotomy is a novel minimally invasive surgical technique that weakens rectus muscles to treat small-angle strabismus. The mini-tenotomy is an alternative to the standard rectus muscle recession that requires hooking the muscle, suturing the muscle, removing the muscle from sclera, and reattaching the muscle to sclera.
This is a retrospective chart review of outcomes of the mini-tenotomy procedure on 15 consecutive adult patients. A central tenotomy of 3 mm was performed cutting through intact conjunctiva using a blunt Westcott scissors.
Preoperatively 6 patients were esotropic, measuring between 2 and 16Delta (mean, 8Delta), and 9 patients had vertical deviations that measured between 2 and 6Delta (mean, 3.5Delta). Final postoperative esodeviations ranged from 1 to 8Delta (mean, 5.8Delta), and hyperdeviations ranged from 0 to 4Delta (mean, 1.3Delta). Final improvement of the deviation was larger for hypertropia, with a mean of 2.3Delta, vs esotropia, with a mean of 1.3Delta.
The mini-tenotomy is a safe and effective treatment for diplopia caused by a small-angle hypertropia or esotropia. It is a minimally invasive surgery that can be done in office with topical anesthesia. As with any strabismus procedure, more than one surgery may be necessary.
微型直肌切断术是一种新型的微创手术技术，通过削弱直肌来治疗小角度斜视。微型直肌切断术是标准直肌后徙术的一种替代方法，标准直肌后徙术需要钩住肌肉、缝合肌肉、从巩膜上分离肌肉并将肌肉重新附着于巩膜。
这是一项对连续15例成年患者进行微型直肌切断术结果的回顾性病历分析。使用钝头的韦斯科特剪刀在完整的结膜上进行3毫米的中央直肌切断术。
术前，6例患者为内斜视，斜视度在2至16三棱镜度（平均8三棱镜度）之间，9例患者有垂直斜视，斜视度在2至6三棱镜度（平均3.5三棱镜度）之间。术后最终内斜视度范围为1至8三棱镜度（平均5.8三棱镜度），上斜视度范围为0至4三棱镜度（平均1.3三棱镜度）。上斜视的最终斜视度改善更大，平均为2.3三棱镜度，而内斜视平均为1.3三棱镜度。
微型直肌切断术是治疗小角度上斜视或内斜视所致复视的一种安全有效的方法。它是一种微创手术，可在门诊局部麻醉下进行。与任何斜视手术一样，可能需要不止一次手术。
