Wan Lu-Qin, Wan Xiao-Mei, Gong Hua-Qing, Xie Li-Xin
Medical College of Qingdao University, Qingdao 266000, Shandong Province, China.
Qingdao Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
Int J Ophthalmol. 2020 Apr 18;13(4):637-642. doi: 10.18240/ijo.2020.04.17. eCollection 2020.
To investigate the therapeutic effects of simultaneous horizontal and vertical operations on dissociated vertical deviation (DVD) associated with other deviations.
Forty-five cases of DVD with horizontal and torsional strabismus underwent combined operation were collected retrospectively. All clinical records were analyzed. All patients were followed up for 6 to 24mo. Wilcoxon signed-ranks test was performed to evaluate the changes of vertical and horizontal deviation. test was used to evaluate the changes of binocular visual function.
Forty-five cases included 36 patients with intermittent exotropia and binocular inferior oblique overaction (IOOA), 5 patients with concomitant esotropia and binocular IOOA, 4 patients with intermittent exotropia and monocular superior oblique palsy. The superior rectus recession (SRR) combined with horizontal rectus recession and the myectomy of inferior oblique or anterior transposition were operated simultaneously to correct all types of strabismus. There were 43 cases who achieved normal eye position in vertical direction, while 2 cases were with undercorrection of 5 to 6. In patients with horizontal strabismus, 2 cases of exotropia were with overcorrection of 6 to 8, 1 case of esotropia was with undercorrection of 6, and 1 case of monocular superior oblique palsy with compensatory head posture was not significantly improved. The binocular visual function of most patients recovered after operation. The difference of the binocular visual function and eye position were significant compared with that before operation (<0.05).
The simultaneous operation on DVD with horizontal and torsional strabismus is successful.
探讨水平与垂直联合手术治疗合并其他斜视的分离性垂直偏斜（DVD）的疗效。
回顾性收集45例合并水平及旋转斜视的DVD患者行联合手术的临床资料。对所有临床记录进行分析。所有患者随访6至24个月。采用Wilcoxon符号秩和检验评估垂直和水平偏斜的变化。采用 检验评估双眼视功能的变化。
45例患者中，36例为间歇性外斜视合并双眼下斜肌亢进（IOOA），5例为共同性内斜视合并双眼IOOA，4例为间歇性外斜视合并单眼上斜肌麻痹。同时行上直肌后徙（SRR）联合水平直肌后徙及下斜肌切除术或下斜肌前转位术矫正各类斜视。垂直方向43例眼位恢复正常，2例欠矫5至6 。水平斜视患者中，2例外斜视过矫6至8 ，1例内斜视欠矫6 ，1例单眼上斜肌麻痹伴代偿头位改善不明显。多数患者术后双眼视功能恢复。术后双眼视功能及眼位与术前相比差异有统计学意义（<0.05）。
水平与旋转斜视合并DVD的联合手术效果良好。
