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单侧下斜肌前转位术治疗明显非对称分离性垂直斜视伴单侧下斜肌亢进

Unilateral inferior oblique anterior transposition for markedly asymmetric dissociated vertical deviation with unilateral inferior oblique over-action.

机构信息

Department of Ophthalmology, Zhejiang Medicine and Western Medicine integrated Hospital (Hangzhou Red-Cross Hospital), 208 Huancheng Road East, Hangzhou, 310003, Zhejiang, China.

出版信息

BMC Ophthalmol. 2019 Aug 28;19(1):196. doi: 10.1186/s12886-019-1205-z.

Abstract

BACKGROUND

To evaluate the results of unilateral inferior oblique anterior transposition (IOAT) for markedly asymmetric dissociated vertical deviation (DVD) combined with inferior oblique over-action (IOOA).

METHODS

Retrospective chart review of the records of all patients with asymmetric DVD combined with unilateral IOOA in the non-dominant eye who received unilateral IOAT on the non-dominant eye. No other muscles were operated on simultaneously. The amount of DVD and IOOA were measured before and after the operation and statistically analysed.

RESULTS

Seventeen patients were included. The mean age at surgery was 23.5 ± 8.4 (range 12-38) years old. The mean postoperative follow-up period was 15.7 ± 7.2 (range 6-32) months. The primary position DVD was 19.6 ± 5.4 (range 14-36) PD preoperatively and decreased significantly to 2.9 ± 2.0 (range 0-8) PD postoperatively (P < 0.01). Preoperatively, there were 2, 7, and 8 patients with + 1, + 2, and + 3 IOOA, respectively, and these were reduced from 2.4 ± 0.7 to 0.3 ± 0.4 postoperatively (P < 0.01). None of the patients were complicated obvious hypotropia, anti-elevation syndrome or IOOA in the contralateral eye.

CONCLUSIONS

Unilateral IOAT was recommended in patients with asymmetric DVD coexists with unilateral IOOA.

摘要

背景

评估明显不对称分离性垂直斜视(DVD)合并下斜肌亢进(IOOA)的单侧下斜肌前移位(IOAT)的结果。

方法

回顾性分析所有非优势眼单侧 IOOA 合并不对称 DVD 的患者记录,非优势眼接受单侧 IOAT。同时不进行其他肌肉手术。手术前后测量 DVD 和 IOOA 的量,并进行统计学分析。

结果

纳入 17 例患者。手术时的平均年龄为 23.5±8.4(范围 12-38)岁。平均术后随访时间为 15.7±7.2(范围 6-32)个月。第一眼位 DVD 术前为 19.6±5.4(范围 14-36)PD,术后显著降低至 2.9±2.0(范围 0-8)PD(P<0.01)。术前分别有 2、7 和 8 例患者存在+1、+2 和+3 IOOA,术后分别减少至 2.4±0.7 和 0.3±0.4(P<0.01)。无患者出现明显下斜肌减弱、反抬高综合征或对侧眼 IOOA。

结论

对于合并单侧 IOOA 的不对称 DVD 患者,建议行单侧 IOAT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2924/6712879/e4a11d59bc35/12886_2019_1205_Fig1_HTML.jpg

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