Wright K W, Lanier A B
Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles.
J Pediatr Ophthalmol Strabismus. 1991 Mar-Apr;28(2):77-81. doi: 10.3928/0191-3913-19910301-06.
Removal of a rectus muscle results in permanent interruption of blood flow in the corresponding anterior ciliary artery, predisposing to anterior segment ischemia (ASI). A subhuman primate model of ASI was developed in order to study a novel muscle tuck procedure designed to preserve anterior ciliary artery circulation. Fluorescein angiograms were obtained before and after surgery to determine the effect of the muscle surgery on iris circulation. A total of 12 eyes from 12 cynomolgus monkeys underwent strabismus surgery consisting of tenectomy of all 4 rectus muscles in 3 eyes, tenectomy of 3 rectus muscles in 3 eyes, and tenectomy of 3 rectus muscles and muscle to sclera tuck of the remaining recti in 6 eyes. Postoperative angiograms documented preservation of perfusion in the distribution of the tucked muscle in all cases except one, in which there was iatrogenic trauma and disruption of anterior ciliary arteries. The modified tuck procedure thus appears to preserve anterior ciliary artery blood flow, and may be useful as a muscle strengthening procedure in patients predisposed to developing ASI.
直肌切除会导致相应睫状前动脉血流永久性中断，易引发眼前段缺血（ASI）。为研究一种旨在保留睫状前动脉循环的新型肌肉折叠手术，构建了一个非人灵长类动物ASI模型。术前和术后均进行荧光素血管造影，以确定肌肉手术对虹膜循环的影响。12只食蟹猴的12只眼睛接受了斜视手术，其中3只眼睛的4条直肌全部进行了肌腱切断术，3只眼睛的3条直肌进行了肌腱切断术，6只眼睛的3条直肌进行了肌腱切断术，其余直肌进行了肌肉至巩膜折叠术。术后血管造影显示，除1例因医源性创伤导致睫状前动脉中断外，所有病例中折叠肌肉分布区域的灌注均得以保留。因此，改良的折叠手术似乎可以保留睫状前动脉血流，对于易发生ASI的患者，该手术作为一种肌肉强化手术可能是有用的。
