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滑动成形眼外肌移位加折叠术:长期结果。

Sliding shape extraocular muscle transposition with plication: Long-term results.

机构信息

Beyoglu Eye Research and Training Hospital, University of Health Science, Istanbul, Turkey.

出版信息

Int Ophthalmol. 2021 Nov;41(11):3593-3598. doi: 10.1007/s10792-021-01932-9. Epub 2021 Jul 3.

Abstract

AIM

This study aims to evaluate the long-term results of sliding shape extraocular muscle transposition, which is a novel operation method of delivering both vascular protection and strengthening of the muscles and transposition of the muscles.

METHODS

The patients' files were scanned retrospectively. All patients underwent a complete eye examination in addition to motility examination, both preoperatively and postoperatively. Patients were followed up for at least 1 year. Pre- and postoperative deviation measurement values and transposition effects were compared statistically. The two parameters were evaluated separately.

RESULTS

In patients where 7-mm (or greater) resection was planned, the complete muscle widening transposition procedure was successful. Only two-thirds of transpositions could be achieved in patients who underwent less than 7 mm of strengthening. There was no anterior segment ischemia in the patients who underwent three rectus' muscle surgery in the same eye. Transposition effects were perfect in those whose vertical deviation was not due to monocular elevation deficiency. While resection effect was excellent in those MED (monocular elevation deficiency) and CEOMF (congenital extraocular muscle fibrosis) cases, transposition effects were limited but found at similar rates as with the standard resection and transposition procedures in CCDD (congenital cranial dis-innervation diseases) (R2-1).

CONCLUSION

Even transposition effects were limited in CCDD. 'Sliding shape' design extraocular muscle plication was found to be a simple, safe, and effective procedure for patients who needed resection and transposition operation.

摘要

目的

本研究旨在评估滑动形眼外肌移位术的长期效果,这是一种既能提供血管保护又能增强肌肉和移位肌肉的新型手术方法。

方法

回顾性扫描患者的档案。所有患者均接受了完整的眼部检查,除了运动检查,术前和术后均进行。患者随访至少 1 年。对术前和术后的偏斜测量值和移位效果进行了统计学比较。这两个参数分别进行评估。

结果

在计划进行 7 毫米(或更大)切除术的患者中,完整的肌肉加宽移位手术成功。在强化程度小于 7 毫米的患者中,只有三分之二的患者可以进行转位。在同一只眼接受三条直肌手术的患者中,没有前段缺血。对于那些垂直偏差不是由于单眼抬高不足引起的患者,转位效果非常好。在 MED(单眼抬高不足)和 CEOMF(先天性眼外肌纤维化)患者中,切除效果极佳,但转位效果有限,但与标准切除和转位手术相似,在 CCDD(先天性颅神经发育不良)中(R2-1)。

结论

即使在 CCDD 中,转位效果也有限。“滑动形”设计的眼外肌折叠术对于需要进行切除和转位手术的患者来说是一种简单、安全、有效的方法。

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