Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan.
Am J Ophthalmol. 2013 Oct;156(4):819-24. doi: 10.1016/j.ajo.2013.05.020. Epub 2013 Jul 20.
To report a simple muscle transposition procedure without tenotomy or muscle splitting to treat abducens palsy.
Retrospective, interventional, consecutive case series.
Nine patients with esotropia resulting from abducens palsy whose eyes could not abduct beyond the midline underwent this muscle transposition procedure, in which a suture was inserted through the temporal margin of each vertical rectus muscle. The same monofilament suture also was inserted into each inferotemporal or superotemporal sclera. The lateral margin of each vertical rectus muscle was transposed superotemporally or inferotemporally and was sutured onto the sclera. All 9 patients underwent unilateral muscle transposition, and 6 of the 9 underwent a medial rectus muscle recession combined with muscle transposition in the same eye.
The surgical correction by muscle transposition alone ranged from 24 to 36 prism diopters, and that by muscle transposition and recession of the medial rectus muscle ranged from 50 to 62 prism diopters. The mean correction was 46.3 ± 13.1 prism diopters per eye. All paretic eyes could abduct beyond the midline. No major vertical ductional disturbances developed. Anterior segment ischemia did not occur in any patients.
This procedure, which achieved the same corrective results as other popular procedures, is simple to perform because it requires only a suture from the muscle to sclera. Tenotomy or splitting of the transposed muscles is unnecessary.
报告一种无需肌腱切断或肌分离的简单肌肉转位术，以治疗展神经麻痹。
回顾性、干预性、连续病例系列。
9 例因展神经麻痹导致内斜视且眼球不能超过中线外展的患者接受了这种肌肉转位术，在该手术中，缝线穿过每条垂直直肌的颞缘。同样的单丝缝线也被插入每个下颞或上颞巩膜。每条垂直直肌的外侧缘被转位到上颞或下颞，并缝合到巩膜上。所有 9 例患者均行单侧肌肉转位，其中 6 例在同一眼行内直肌后退术联合肌肉转位。
单纯肌肉转位的手术矫正范围为 24 至 36 棱镜度，肌肉转位和内直肌后退的手术矫正范围为 50 至 62 棱镜度。平均每只眼矫正 46.3 ± 13.1 棱镜度。所有麻痹眼均可超过中线外展。没有出现明显的垂直运动障碍。没有患者发生前段缺血。
与其他流行的手术方法相比，该方法具有相同的矫正效果，操作简单，因为它只需要一条从肌肉到巩膜的缝线。无需进行转位肌肉的肌腱切断或分离。
