Leenheer Rebecca S, Wright Kenneth W
Loma Linda University, Ophthalmology, Loma Linda, California, USA.
J AAPOS. 2012 Aug;16(4):327-30. doi: 10.1016/j.jaapos.2012.02.018.
Mini-plication is a new rectus muscle tightening procedure for the correction of small-angle strabismus that can be performed under topical anesthesia. The purpose of this study was to report the outcomes of mini-rectus muscle plication.
We retrospectively reviewed the medical records of patients who underwent mini-plication. In this procedure, 6-0 polyglactin 910 suture was secured to the central 3 to 4 mm of the muscle belly 5 mm posterior to the insertion and was then passed through the sclera just anterior to the muscle insertion to plicate the central portion of the muscle. This differs from the standard procedure, in which the entire width of the muscle is plicated. Two groups were analyzed: those who underwent mini-plication alone and those who underwent mini-plication after prior antagonist muscle-weakening surgery.
Our review identified nine patients aged 5 to 78 years. Topical anesthesia was used for all adults, who experienced no local or systemic complications. Mini-plication reduced vertical and horizontal deviations an average (± SD) of 6.7(Δ) ± 3.5(Δ). The mini-plication-only group (3 patients) had an average postoperative correction of 5.5(Δ) ± 2.6(Δ); the prior surgery group (6 patients), an average of 9(Δ) ± 2.7(Δ). Diplopia was noted in 50% of the adults preoperatively and none postoperatively. All patients experienced a decrease in strabismus, with an average outcome of <5(Δ) of postoperative deviation.
Mini-plication, which can be performed under topical anesthesia, corrected small deviations and was especially useful for adult strabismus patients with diplopia.
微型折叠术是一种用于矫正小角度斜视的新型直肌收紧手术，可在表面麻醉下进行。本研究的目的是报告微型直肌折叠术的结果。
我们回顾性分析了接受微型折叠术患者的病历。在该手术中，将6-0聚乙醇酸910缝线固定在肌肉附着点后方5mm处肌腹中央3至4mm处，然后穿过肌肉附着点前方的巩膜以折叠肌肉中央部分。这与标准手术不同，标准手术是折叠肌肉的整个宽度。分析了两组：仅接受微型折叠术的患者和在先前拮抗肌减弱手术后接受微型折叠术的患者。
我们的回顾确定了9例年龄在5至78岁之间的患者。所有成年人均使用表面麻醉，未出现局部或全身并发症。微型折叠术使垂直和水平斜视度平均（±标准差）降低了6.7（三棱镜度）±3.5（三棱镜度）。仅接受微型折叠术的组（3例患者）术后平均矫正度为5.5（三棱镜度）±2.6（三棱镜度）；先前手术组（6例患者）平均为9（三棱镜度）±2.7（三棱镜度）。50%的成年人术前有复视，术后无复视。所有患者的斜视均有所减轻，术后斜视度平均结果<5（三棱镜度）。
微型折叠术可在表面麻醉下进行，矫正小角度斜视，对伴有复视的成年斜视患者尤其有用。
