Chang Jee Ho, Kim Hoon Dong, Lee Jong Bok, Han Sueng-Han
Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon, Korea.
Korean J Ophthalmol. 2011 Apr;25(2):139-41. doi: 10.3341/kjo.2011.25.2.139. Epub 2011 Mar 11.
In cases of extropia with an exodeviation angle over 50 prism diopter (PD), a 3- or 4-muscle surgery is a rational option. But, in patients with sensory exotropia, there is usually a strong preference for a monocular procedure to avoid surgery on the single seeing eye. Thus, we confined surgery to visually poor eyes, and performed a medial rectus muscle resection with a mean of 10.3 mm (range, 9-11 mm) and a lateral rectus muscle recession with a mean of 12.8 mm (range, 10-14 mm) in 4 adult sensory exotropia patients who had a mean deviation of 82.3 PD (range, 75-90 PD). The mean postoperative angle of exodeviation was 2.0 PD (range, ortho-8 PD). The limitation on abduction was not disfiguring. Other expected disfigurements, such as narrowing of the palpebral fissure or enophthalmos, were not conspicuous. The mean follow-up period was 4.5 months (range, 3-7 months). In large-angle sensory exotropia, instead of additive surgery on the seeing eye, supermaximal medial rectus resection and lateral rectus recession only on the visually poor eye is a clinically feasible surgical option.
对于外斜视且外斜视角超过50棱镜度（PD）的病例，进行三肌或四肌手术是一种合理的选择。但是，对于感觉性外斜视患者，通常强烈倾向于采用单眼手术，以避免对单眼视力的眼睛进行手术。因此，我们将手术局限于视力较差的眼睛，对4例平均斜视度为82.3 PD（范围为75 - 90 PD）的成年感觉性外斜视患者进行了内直肌平均10.3 mm（范围为9 - 11 mm）的切除术和外直肌平均12.8 mm（范围为10 - 14 mm）的后徙术。术后平均外斜视角为2.0 PD（范围为正位至8 PD）。外展受限并不影响外观。其他预期的外观改变，如睑裂狭窄或眼球内陷，并不明显。平均随访期为4.5个月（范围为3 - 7个月）。在大角度感觉性外斜视中，不对视力好的眼睛进行附加手术，仅对视力差的眼睛进行超最大量的内直肌切除术和外直肌后徙术是一种临床上可行的手术选择。
