Bingöl Women's Health and Children's Hospital, Department of Ophthalmology, Bingöl, Turkey.
Ulucanlar Eye Training and Research Hospital, Clinic of Ophthalmology, Ankara, Turkey.
Turk J Ophthalmol. 2020 Apr 29;50(2):82-86. doi: 10.4274/tjo.galenos.2019.87947.
To investigate the surgical results of the inferior oblique muscle Z-myotomy in patients with inferior oblique muscle overaction (IOOA).
The medical records of patients who had undergone inferior oblique muscle Z-myotomy for primary IOOA in a single center between 2017 and 2018 were retrospectively analyzed. All patients had mild IOOA (+1 and between +1 and +2). Preoperative and postoperative IOOA degrees and ocular motility examinations were evaluated. Inferior oblique muscle Z-myotomy is performed at 6 mm along the physiological muscle line after identifying the lower oblique muscle through an inferotemporal fornix incision.
Forty-seven eyes of 44 patients were included in the study. The patients were divided into those with +1 IOOA (n=37, 78.7%) and those with +1-2 IOOA (n=10, 21.3%). The mean age of the +1 group was 14.18±11.8 years and the mean age of the +1-2 group was 13.40±7.45 years. The mean follow-up time was 10.56±8.7 (6-17) months. Bilateral Z-myotomy was performed in 3 (6.8%) and unilateral in 41 (93.2%) of the patients. IOOA correction was observed in 43 (91.4%) of the 47 eyes after Z-myotomy, while 4 (8.6%) eyes still had preoperative levels of IOOA. There was no statistically significant difference in surgical success rate between the groups (p=0.849). When preoperative and postoperative IOOA values were compared, there was a statistically significant decrease in IOOA values in the postoperative period (p=0.001). No intraoperative or postoperative complications were observed.
Inferior oblique Z-myotomy is a simple, fast, sutureless surgical procedure in which the original muscle insertion is preserved. Z-myotomy of the inferior oblique muscle can be used as a successful attenuation method in patients with minimal IOOA.
探讨下斜肌 Z 切开术治疗下斜肌亢进（IOOA）的手术效果。
回顾性分析 2017 年至 2018 年期间在单中心接受下斜肌 Z 切开术治疗原发性 IOOA 的患者的病历。所有患者均为轻度 IOOA（+1 及+1 至+2）。评估术前和术后 IOOA 度数和眼球运动检查。通过颞下穹窿切口识别下斜肌后，在下斜肌生理肌线 6mm 处进行下斜肌 Z 切开术。
44 例患者的 47 只眼纳入研究。患者分为+1 IOOA 组（n=37，78.7%）和+1-2 IOOA 组（n=10，21.3%）。+1 组的平均年龄为 14.18±11.8 岁，+1-2 组的平均年龄为 13.40±7.45 岁。平均随访时间为 10.56±8.7（6-17）个月。3 只眼（6.8%）行双侧 Z 切开术，41 只眼（93.2%）行单侧 Z 切开术。47 只眼中，43 只眼（91.4%）在 Z 切开术后 IOOA 得到矫正，4 只眼（8.6%）仍有术前 IOOA 水平。两组手术成功率无统计学差异（p=0.849）。比较术前和术后 IOOA 值，术后 IOOA 值明显降低，差异有统计学意义（p=0.001）。术中及术后均无并发症发生。
下斜肌 Z 切开术是一种简单、快速、无需缝线的手术，保留了原有肌止点。下斜肌 Z 切开术可作为治疗轻度 IOOA 的有效减弱方法。
