Choi Se Rang, Baek Seung-Hee, Samuel Kim Ungsoo
Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University, College of Medicine Seoul Korea.
Neuroophthalmology. 2013 Jan 29;37(1):41-42. doi: 10.3109/01658107.2012.738758. eCollection 2013.
We report the effect of horizontal extraocular muscle surgery of Heimann-Bielshowsky phenomenon. A 52-year-old woman complained of binocular diplopia for a few months. In 2000, she underwent extracapsular cataract extraction with intraocular lens implantation in the right eye. After surgery, the diplopia persisted and developed further. She showed an esodeviation of 60 prism dioptres at near fixation and distance fixation. Cortical opacity and nucleus sclerosis were observed in the left lens, and phacoemulsification with intraocular lens implantation was performed in the left eye in October 2011. After cataract surgery, the patient suffered from oscillopsia and diplopia. Examination revealed unilateral coarse, slow, pendular vertical oscillations in the right eye and an esodeviation of 45 prism dioptres and a right hypodeviation of 8 prism dioptres, which were observed before the surgery. We performed a medial rectus muscle 6 mm recession and lateral rectus muscle 7 mm resection surgery on the right eye. After the operation, the oscillations disappeared and diplopia greatly improved. Moreover, the patient no longer complained of oscillopsia. We conclude that surgery performed on horizontal extraocular muscles could be an effective treatment for Heimann-Bielschowsky phenomenon also.
我们报告了水平眼外肌手术对海曼-比尔绍夫斯基现象的影响。一名52岁女性主诉双眼复视数月。2000年，她右眼接受了白内障囊外摘除联合人工晶状体植入术。术后，复视持续并进一步发展。她在近注视和远注视时表现出60棱镜度的内斜视。左眼观察到皮质混浊和核硬化，2011年10月左眼进行了超声乳化白内障吸除联合人工晶状体植入术。白内障手术后，患者出现视振荡和复视。检查发现右眼有单侧粗大、缓慢、摆动性垂直振荡，术前观察到有45棱镜度的内斜视和8棱镜度的右眼低位偏斜。我们对右眼进行了内直肌6毫米后徙和外直肌7毫米切除术。术后，振荡消失，复视明显改善。此外，患者不再抱怨视振荡。我们得出结论，水平眼外肌手术也可能是治疗海曼-比尔绍夫斯基现象的有效方法。
