Wójcik E, Krzystkowa K M, Kubatko-Zielińska A
Oddziału Leczenia Zeza i Niedowidzenia Krakowskiego Szpitala Okulistycznego, Poland.
Klin Oczna. 1990 Dec;92(11-12):212-4.
The authors present a group of 3500 patients treated surgically in the years 1961-1986 for disturbances of function of the oblique muscles. Two forms of these disturbances are discussed. The first one--acquired paresis of the trochlearis muscle, most frequently a sequelae of injury, the second one--congenital disturbances of action of the superior oblique, with hyperfunction of the inferior oblique, determined as "strabismus sursoadductorius". When the healthy eye was the master eye one the authors performed operations weakening the inferior oblique which was in hyperfunction (recession, partial marginal tenotomy, myectomy, elongation) or they strengthened the superior oblique (plication) because of its paresis. In patients with the affected eye as the master one they weakened the opposite inferior rectus (recession) or strengthened the opposite superior rectus (resection). In cases of a coexistence of a horizontal deviation also this deviation was treated surgically. Five thousand seven hundred four operations had been performed. The vertical deviation was corrected in 75.5 p.c. and diminished in 24 p.c. Binocular single vision without compensatory positioning of the head was attained in 55.4 p.c. of patients, with a small compensatory positioning of the head--in 10.8 p.c.
作者介绍了1961年至1986年间接受手术治疗的3500例斜肌功能障碍患者。文中讨论了这些功能障碍的两种形式。第一种是滑车神经麻痹,最常见的是损伤后遗症;第二种是上斜肌先天性功能障碍,伴有下斜肌功能亢进,被定义为“上斜肌内转性斜视”。当健眼为主眼时,作者对功能亢进的下斜肌进行手术减弱(后徙、部分边缘腱切断术、肌切除术、延长术),或因上斜肌麻痹而加强上斜肌(折叠术)。当患眼为主眼时,他们减弱对侧下直肌(后徙)或加强对侧上直肌(缩短术)。在存在水平斜视的病例中,也对这种斜视进行手术治疗。共进行了5704例手术。垂直斜视得到矫正的占75.5%,减轻的占24%。55.4%的患者获得了无头部代偿性定位的双眼单视,有小幅度头部代偿性定位的占10.8%。