Akar Serpil, Gökyiğit Birsen, Yilmaz Omer Faruk
Beyoğlu Education and Research Eye Hospital, Istanbul, Turkey.
J AAPOS. 2012 Jun;16(3):286-90. doi: 10.1016/j.jaapos.2012.01.009.
To evaluate the efficacy of bilateral graded anterior transposition of the inferior oblique muscle for the correction of V-pattern strabismus associated with inferior oblique overaction.
Medical records of patients who underwent graded anterior transposition of the inferior oblique muscle for bilateral primary inferior oblique overaction associated with V-pattern strabismus were reviewed. The surgical technique entailed recessing and anteriorly transposing the inferior oblique muscle to various locations along the temporal border of the inferior rectus muscle. The amount of anterior transposition was determined by both the severity of the overaction and the extent of the V pattern. We analyzed the changes in inferior oblique muscle overaction and V-pattern strabismus and the frequency of limited elevation after surgery.
The record review identified 69 patients (138 eyes) who met inclusion criteria. V-pattern esotropia was present in 44 patients (64%) and V-pattern exotropia in 25 (36%). Full correction or undercorrection to <10(Δ) of V pattern was achieved in 82% of esotropia cases and 80% of exotropia cases. Response to surgery was influenced by the severity of the preoperative inferior oblique muscle overaction and the extent of the preoperative V pattern. The grading of the anterior transposition was not a significant independent predictor of surgical response. No patient suffered limitation of elevation postoperatively.
Anterior transposition of the inferior oblique muscles corrected V-pattern strabismus and reduced inferior oblique muscle overaction without creating limitation of elevation; however, it is unclear whether grading the transposition contribute to the success of the procedure.
评估双侧下斜肌分级前徙术矫正与下斜肌亢进相关的V型斜视的疗效。
回顾接受双侧下斜肌分级前徙术治疗与V型斜视相关的原发性双侧下斜肌亢进患者的病历。手术技术包括将下斜肌后徙并沿下直肌颞侧缘向前移位至不同位置。前徙量由亢进的严重程度和V型的程度决定。我们分析了术后下斜肌亢进和V型斜视的变化以及上转受限的发生率。
病历回顾确定了69例（138眼）符合纳入标准的患者。44例（64%）为V型内斜视，25例（36%）为V型外斜视。82%的内斜视病例和80%的外斜视病例实现了V型的完全矫正或欠矫至<10（Δ）。手术反应受术前下斜肌亢进的严重程度和术前V型程度的影响。前徙分级不是手术反应的显著独立预测因素。术后无患者出现上转受限。
下斜肌前徙术矫正了V型斜视并减少了下斜肌亢进，且未造成上转受限；然而，尚不清楚分级前徙是否有助于手术成功。
