Dawson E, Ali N, Lee J P
Moorfields Eye Hospital, London, UK.
Strabismus. 2012 Mar;20(1):24-5. doi: 10.3109/09273972.2011.650814.
Botulinum toxin injected into the superior rectus (SR) has rarely been described in the literature. We conducted a database search to identify all cases of SR toxin from 1982 to 2010 at our institution. Out of a total of 7575 patients in the database, only eight cases of SR toxin were identified, all of which had residual hypertropia following previous ocular surgery. This surgery comprised: retinal surgery (3 patients), strabismus surgery for thyroid eye disease (2), and transposition for VI nerve palsy (2 patients). In seven out of eight cases, a long-lasting mean reduction of 10(Δ) was achieved from between two and three injections. Ptosis occurred in all but one case, but resolved. We conclude that SR toxin injection has very limited indications, but may be considered in residual hypertropia presumed secondary to a tight or overacting SR where the patient can tolerate the temporary iatrogenic ptosis.
肉毒杆菌毒素注射到上直肌（SR）在文献中鲜有描述。我们进行了数据库检索，以确定1982年至2010年在我们机构接受SR毒素治疗的所有病例。在数据库中的7575名患者中，仅识别出8例SR毒素治疗病例，所有这些病例在先前的眼部手术后均有残余上斜视。该手术包括：视网膜手术（3例患者）、甲状腺眼病斜视手术（2例）和第六脑神经麻痹移位术（2例患者）。在8例中的7例中，通过两到三次注射实现了平均10（Δ）的长期降低。除1例病例外，所有病例均出现上睑下垂，但均已恢复。我们得出结论，SR毒素注射的适应证非常有限，但对于推测继发于紧张或过度活跃的SR导致的残余上斜视，且患者能够耐受暂时性医源性上睑下垂的情况，可考虑使用。
