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根据单侧外斜视型杜安眼球后退综合征的继发性斜视测量结果评估双侧外直肌后徙术的疗效

The Efficacy of Bilateral Lateral Rectus Recession According to Secondary Deviation Measurements in Unilateral Exotropic Duane Retraction Syndrome.

作者信息

Mezad-Koursh Daphna, Leshno Ari, Klein Ainat, Stolovich Chaim

出版信息

J Pediatr Ophthalmol Strabismus. 2018 Jan 1;55(1):47-52. doi: 10.3928/01913913-20170703-14. Epub 2017 Oct 9.

Abstract

PURPOSE

To evaluate the surgical results of asymmetric bilateral lateral rectus recession in exotropic Duane retraction syndrome with abnormal face turn toward the opposite side according to secondary deviation measurements.

METHODS

Retrospective chart review.

RESULTS

Seven cases of unilateral exotropic Duane retraction syndrome were reviewed. All cases had globe retraction on adduction and exotropia with limited adduction, five of which also had mild limitation of abduction. Four cases had upshoot/downshoot on adduction and all patients had face turn. Exotropia was measured in forced primary position. The average lateral rectus recession was 6.36 mm (range: 5.5 to 7.5 mm) in the affected eye and 7.36 mm (range: 6.5 to 8.5 mm) in the healthy eye. The mean follow-up period was 282 days. Mean exotropia in the forced primary position improved from 27.9 ± 5.7 prism diopters (PD) preoperatively to 7.9 ± 16.8 PD postoperatively (P = .025). Head position resolved completely in all but one case (P =.031). There were no significant changes in ductions.

CONCLUSIONS

The results suggest that asymmetric bilateral lateral rectus recession in exotropic Duane retraction syndrome with abnormal head turn posture successfully eliminates abnormal head turn posture and exotropia in most cases. [J Pediatr Ophthalmol Strabismus. 2018;55(1):47-52.].

摘要

目的

根据继发斜视度测量结果,评估外斜视型杜安眼球后退综合征伴向对侧异常面部转动患者行不对称双侧外直肌后徙术的手术效果。

方法

回顾性病历分析。

结果

回顾了7例单侧外斜视型杜安眼球后退综合征患者。所有病例均存在内收时眼球后退及外斜视伴内收受限,其中5例还伴有轻度外展受限。4例内收时有上转/下转,所有患者均有面部转动。在强迫第一眼位测量外斜视度。患眼外直肌平均后徙量为6.36mm(范围:5.5至7.5mm),健眼为7.36mm(范围:6.5至8.5mm)。平均随访期为282天。强迫第一眼位的平均外斜视度从术前的27.9±5.7棱镜度(PD)改善至术后的7.9±16.8PD(P = 0.025)。除1例患者外,所有患者的头位均完全恢复(P = 0.031)。眼球运动无显著变化。

结论

结果表明,对于伴有异常头位姿势的外斜视型杜安眼球后退综合征患者,不对称双侧外直肌后徙术在大多数情况下可成功消除异常头位姿势和外斜视。[《小儿眼科与斜视杂志》。2018;55(1):47 - 52。]

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