Ameri Ahmad, Jafari Alireza K, Anvari Faramarz, Ahadzadeghan Iraj, Rajabi Mohammad Taher
Department of Ophthalmology, School of Medicine, Medical Sciences, Tehran University, Iran.
Binocul Vis Strabismus Q. 2010;25(1):21-30.
PURPOSE: To intruduce a new method for rectus muscle recession in order to minimize the riSk of a lost or slipped muscle and scleral perforation and compare it with the conventional method. PATIENTS AND METHODS: In a prospective study between May 2002 and December 2006, 69 patients underwent recession with the modified technique, and 50 patients underwent recession with the conventional method. We compared the results of strabismus surgery in these non-randomized series with esotropia or exotropia treated with conventional surgery with the modified technique surgery. Patients in the modified technique group were high risk patients that had large angle recession, thin sclera or less exposure sugical field. RESULTS: Surgical outcomes were not significantly different in the two treatment groups that based on their findings had been classified into four subgroups. No complications such as globe penetration, muscle slippage or lost muscle were observed during the follow up period of 12 months. CONCLUSIONS: It seems that the modified method introduced in this study can reduce the complications and risks involved in conventional and suspension-recession methods and it is safe and effective for muscle recession. It can decrease the risk of globe perforation since the sclera behind the insertion is penetrated only superficially because of anchor suturing to the muscle insertion stump, and the possibility of lost or slipped recessed muscles would be minimized.
目的:介绍一种新的直肌后徙术方法,以尽量减少肌肉丢失或滑脱以及巩膜穿孔的风险,并将其与传统方法进行比较。 患者与方法:在2002年5月至2006年12月的一项前瞻性研究中,69例患者采用改良技术进行后徙术,50例患者采用传统方法进行后徙术。我们将这些非随机系列中采用改良技术手术治疗内斜视或外斜视的斜视手术结果与采用传统手术治疗的结果进行了比较。改良技术组的患者为高危患者,有大角度后徙、巩膜薄或手术视野暴露少的情况。 结果:根据研究结果将两个治疗组分为四个亚组,手术结果无显著差异。在12个月的随访期内,未观察到诸如眼球穿透、肌肉滑脱或肌肉丢失等并发症。 结论:本研究中引入的改良方法似乎可以减少传统方法和悬吊后徙术方法所涉及的并发症和风险,并且对于肌肉后徙术是安全有效的。由于通过将锚定缝线缝至肌肉附着残端,插入点后方的巩膜仅被浅表层穿透,因此可以降低眼球穿孔的风险,并且可以将后徙肌肉丢失或滑脱的可能性降至最低。
Binocul Vis Strabismus Q. 2010
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