Yang Shiqiang, Yue Yiying, Wang Ping, Chen Guozhi
Department of Strabismus and Pediatric Ophthalmology, Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
Bright Eye Hospital group, Shanghai, China.
Strabismus. 2020 Mar;28(1):25-28. doi: 10.1080/09273972.2019.1697301. Epub 2019 Nov 28.
: To evaluate the efficacy of single or combined superior oblique tendon (SO) advancement for selected cases of unilateral superior oblique palsy (SOP).: The medical records of 14 patients who underwent single or combined superior oblique tendon advancement in one institution from May 2017 to October 2018 were reviewed. All subjects with a diagnosis of unilateral SOP who underwent single or combined SO tendon advancement surgery were included. The goal of the surgery was to correct the hypertropia and head tilt. The single or combined SO tendon advancement surgery was selected based on the amount of hypertropia or head tilt and the Knapp classification of the SOP. The information recorded included pre- and postoperative deviation angle and ocular motility findings. The degree of upshoot in adduction was graded pre- and postoperatively.: Fourteen patients between the age of 3 and 52 years with unilateral superior oblique palsy were selected to undergo SO tendon advancement. Single SO tendon advancement was carried out in eight acquired Knapp class II or residual SOP patients. SO tendon advancement combined with contralateral inferior rectus recession was carried out in two acquired Knapp class II patients. SO tendon advancement combined with ipsilateral inferior oblique myectomy was carried out in four congenital Knapp class III patients. The changes in pre- and postoperative hypertropia at primary gaze in single SO tendon advancement patients were from 6.25 ± 2.12 prism diopters to 0.86 ± 1.46 prism diopters. The changes in degree of upshoot in adduction were from +1.86 to +0.21. : SO tendon advancement worked well as single or combined muscle procedure to treat unilateral superior oblique palsy.
评估单眼上斜肌麻痹（SOP）特定病例行单条或联合上斜肌腱（SO）前徙术的疗效。回顾了2017年5月至2018年10月在一家机构接受单条或联合上斜肌腱前徙术的14例患者的病历。纳入所有诊断为单眼SOP并接受单条或联合SO肌腱前徙手术的患者。手术目的是矫正上斜视和头位倾斜。根据上斜视或头位倾斜程度以及SOP的Knapp分类选择单条或联合SO肌腱前徙手术。记录的信息包括术前和术后的斜视度及眼球运动结果。内收时上转程度在术前和术后进行分级。选择14例年龄在3至52岁的单眼上斜肌麻痹患者行SO肌腱前徙术。8例获得性Knapp II级或残留SOP患者行单条SO肌腱前徙术。2例获得性Knapp II级患者行SO肌腱前徙联合对侧下直肌后徙术。4例先天性Knapp III级患者行SO肌腱前徙联合同侧下斜肌切除术。单条SO肌腱前徙术患者在第一眼位时术前和术后上斜视的变化从6.25±2.12三棱镜度变为0.86±1.46三棱镜度。内收时上转程度的变化从+1.86变为+0.21。SO肌腱前徙术作为单条或联合肌肉手术治疗单眼上斜肌麻痹效果良好。
