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双侧上斜肌“回退”术治疗伴有上斜肌亢进的A型斜视的疗效

Effects of Bilateral Superior Oblique "Hang-Back" Recession in Treatment of A-pattern Strabismus with Superior Oblique Overaction.

作者信息

Li Yueping, Ma Huizhi, Zhao Kanxing

机构信息

a Tianjin Eye Hospital, Clinical College of Ophthalmology of Tianjin Medical University , Tianjin Key Laboratory of Ophthalmology and Vision Science , Tianjin , China.

出版信息

Strabismus. 2016;24(1):1-6. doi: 10.3109/09273972.2015.1130063. Epub 2016 Mar 8.

Abstract

PURPOSE

To investigate the efficacy and safety of bilateral hang-back recession of superior oblique (SO) muscles in the treatment of A-pattern strabismus with superior oblique overaction (SOOA).

METHODS

Thirty-one (31) patients (62 eyes) with A-pattern horizontal deviation and SOOA underwent hang-back recession of SO and retrospective analysis of the surgical amount of hang-back recession of SO, preoperative and postoperative A-pattern, ocular motility, and corrected objective torsion. Patients were evaluated before and 6 to 9 months after surgery.

RESULTS

The average A-pattern horizontal deviation was 27.58 ± 11.47 prism diopters (PD) before surgery and 3.48 ± 3.70 PD after surgery (n=31, P<0.05). The mean corrected A-pattern was horizontal deviation 24.10 ± 10.32 PD. The average scale of SOOA on a scale of +1 to +4 was +3.05 ± 0.80 before surgery and +0.42 ± 0.50 after surgery in 62 eyes (P<0.05). The mean corrected objective torsion was 4.91° ± 4.53°. The surgical amount of SO hang-back recession ranged from 4 to 10 mm (mean: 7.62 ± 1.18 mm), which was related to the preoperative A-pattern and corrected A-pattern. There were no surgical complications.

CONCLUSIONS

SO hang-back recession is a safe and efficient option for A-pattern caused by SOOA.

摘要

目的

探讨双侧上斜肌(SO)后徙术治疗伴有上斜肌亢进(SOOA)的A型斜视的疗效和安全性。

方法

31例(62眼)伴有A型水平斜视和SOOA的患者接受了SO后徙术,并对SO后徙术的手术量、术前和术后A型斜视、眼球运动以及矫正后的客观旋转进行回顾性分析。在手术前以及术后6至9个月对患者进行评估。

结果

术前平均A型水平斜视度为27.58±11.47棱镜度(PD),术后为3.48±3.70 PD(n = 31,P<0.05)。平均矫正后的A型斜视度为水平斜视24.10±10.32 PD。62眼中,术前SOOA在+1至+4级的平均程度为+3.05±0.80,术后为+0.42±0.50(P<0.05)。平均矫正后的客观旋转度为4.91°±4.53°。SO后徙术的手术量为4至10 mm(平均:7.62±1.18 mm),这与术前A型斜视和矫正后的A型斜视有关。未出现手术并发症。

结论

SO后徙术是治疗由SOOA引起的A型斜视的一种安全有效的选择。

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