Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain.
Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, Spain.
Arch Soc Esp Oftalmol (Engl Ed). 2021 Oct;96(10):545-548. doi: 10.1016/j.oftale.2020.09.012. Epub 2021 Mar 10.
Monocular elevation deficiency (MED) is characterized by unilateral limitation of supraductions, similar in adduction and abduction, in addition to hypotropia and ptosis. We describe a case of a 62-year-old woman with long-standing left ptosis who was initially operated with a frontal suspension technique. On subsequent examinations, a MED of that eye was found. The passive duction test was positive, so the inferior rectus was recessed. In addition, a modified Nishida technique was performed, consisting of the scleral anchorage of the superior edges of the rectus, medial and lateral, 12mm from the corneal limbus in the superonasal and superotemporal quadrants, respectively. Postoperatively, the left eye presented a minimal hypotropia of 3 PD. This modified technnique used here on the horizontal rectus muscles, turned out to be effective and safe for the correction of MED.
单眼上斜视不足（MED）的特征是单侧上转受限，内转和外转相似，伴有下斜视和上睑下垂。我们描述了一位 62 岁的女性，她的左眼长期存在上睑下垂，最初采用额肌悬吊术进行手术。在随后的检查中，发现该眼存在 MED。被动牵拉试验阳性，因此下直肌后退。此外，还进行了改良 Nishida 技术，包括在超鼻上象限和超颞上象限，从角膜缘分别向内侧和外侧各 12mm 处的直肌的上缘进行巩膜固定。术后，左眼出现 3 PD 的最小下斜视。这里对水平直肌使用的改良技术，对于 MED 的矫正效果良好且安全。
