Escuder Anna G, Ranka Milan P, Lee Kathy, Nam Julie N, Steele Mark A
J Pediatr Ophthalmol Strabismus. 2018 Jul 1;55(4):234-239. doi: 10.3928/01913913-20180327-01. Epub 2018 May 29.
To evaluate the clinical outcomes of bilateral superior oblique posterior 7/8th tenectomy with inferior rectus recession on improving chin-up head positioning in patients with horizontal nystagmus.
Medical records were reviewed from 2007 to 2017 for patients with nystagmus and chin-up positioning of 15° or more who underwent combined bilateral superior oblique posterior 7/8th tenectomy with an inferior rectus recession of at least 5 mm.
Thirteen patients (9 males and 4 females) were included, with an average age of 7.3 years (range: 1.8 to 15 years). Chin-up positioning ranged from 15° to 45° degrees (average: 30°). Three patients had prior horizontal muscle surgeries, 1 for esotropia and 2 for horizontal null zones causing anomalous face turns. Ten patients underwent other concomitant eye muscle surgery: 3 had esotropia, 1 had exotropia, and 2 had biplanar nystagmus null point requiring a horizontal Anderson procedure. Four patients underwent simultaneous bilateral medial rectus tenotomy and reattachment. All patients had improved chin-up positioning. Eight patients had complete resolution, whereas 5 had minimal residual chin-up positioning. Three patients developed an eccentric horizontal gaze null point with compensatory anomalous face turn with onset 2 weeks, 2 years, and 3 years postoperatively. Average follow-up was 42.7 months. No postoperative pattern deviations, cyclodeviations, or inferior oblique overaction were seen. No surgical complications were noted.
Bilateral superior oblique posterior 7/8th tenectomy in conjunction with bilateral inferior rectus recession is a safe and effective procedure for improving chin-up head positioning in patients with horizontal nystagmus with a down gaze null point. [J Pediatr Ophthalmol Strabismus. 2018;55(4):234-239.].
评估双侧上斜肌后8分之7切除术联合下直肌后徙术改善水平性眼球震颤患者抬头位的临床效果。
回顾2007年至2017年期间因眼球震颤且抬头位达15°或以上而接受双侧上斜肌后8分之7切除术联合至少5mm下直肌后徙术的患者病历。
纳入13例患者（9例男性，4例女性），平均年龄7.3岁（范围：1.8至15岁）。抬头位范围为15°至45°（平均：30°）。3例患者曾接受过水平肌手术，1例因内斜视，2例因水平性无眼球震颤带导致异常面转。10例患者接受了其他同期眼肌手术：3例有内斜视，1例有外斜视，2例有双平面眼球震颤零点需要行水平安德森手术。4例患者同时接受了双侧内直肌切断术和重新附着术。所有患者的抬头位均有改善。8例患者完全恢复，5例有最小残留抬头位。3例患者术后2周、2年和3年出现偏心性水平注视零点并伴有代偿性异常面转。平均随访42.7个月。未观察到术后模式偏差、旋转斜视或下斜肌亢进。未记录到手术并发症。
双侧上斜肌后8分之7切除术联合双侧下直肌后徙术是改善伴有下视零点的水平性眼球震颤患者抬头位的一种安全有效的手术方法。[《小儿眼科与斜视杂志》。2018；55(4)：234 - 239。]
