Bechac G, Arné J L, Bec P
J Fr Ophtalmol. 1987;10(4):309-22.
Adjustable sutures have been used as a curative procedure in 31 cases of diplopia, 16 cases of plegic causes, 4 cases of acute concomitant squint and 11 cases of mechanical strabismus: thyroid myopathy, orbital fracture, oculomotor imbalance after scleral indentation. In oculomotor paralysis if a few functional motor units remained at plegic muscle level, we were able to obtain new rotational balance by combining, with adjustable sutures, recession and resection of the couple agonist-antagonist. On the other hand, if no functional motor unit remained, it was then necessary to turn to the muscular translocation process modulated by adjustable surgery. In acute concomitant strabismus, adjustable retroposition of the medial rectus enabled us to fall back into an area controlled by fusional vergencies. Lastly, in mechanical strabismus by passive limitation, adjustable sutures usually enabled hyperaction of the contralateral synergists to be controlled and to bind a new rotational balance, compatible with a simple binocular field of vision. The advantage of this technique was to adapt, on adjustment, the motor response to the new innervational background which had disappeared under anaesthesia.
可调缝线已被用作治疗31例复视、16例麻痹性病因、4例急性共同性斜视和11例机械性斜视的方法：甲状腺肌病、眼眶骨折、巩膜压陷后动眼神经失衡。在动眼神经麻痹中，如果麻痹肌肉水平仍有一些功能性运动单位，我们能够通过将可调缝线与拮抗肌对的后徙和切除相结合来获得新的旋转平衡。另一方面，如果没有功能性运动单位留存，则有必要转向可调手术调节的肌肉移位手术。在急性共同性斜视中，内直肌的可调后徙使我们能够回到融合性聚散控制的区域。最后，在被动性限制导致的机械性斜视中，可调缝线通常能够控制对侧协同肌的亢进，并建立与简单双眼视野相适应的新的旋转平衡。该技术的优点是在调整时使运动反应适应麻醉下消失的新的神经支配背景。
