下斜肌腹移位联合下斜肌后退术治疗非对称下斜肌亢进

Efficacy of inferior oblique belly transposition combined with inferior oblique recession for asymmetric inferior oblique overaction.

机构信息

From the Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

出版信息

Can J Ophthalmol. 2024 Feb;59(1):e46-e52. doi: 10.1016/j.jcjo.2022.10.016. Epub 2022 Nov 11.

DOI:10.1016/j.jcjo.2022.10.016

PMID:36372136

Abstract

OBJECTIVE

To evaluate the efficacy of inferior oblique belly transposition (IOBT) combined with inferior oblique (IO) recession in treating bilateral asymmetric inferior oblique overaction (IOOA).

METHODS

A retrospective review. The data of 14 patients who underwent IOBT on the mild side of IOOA and IO recession on the severe side for bilateral asymmetric IOOA were analyzed retrospectively. The main surgical results including the correction of IOOA, hypertropia, horizontal deviation, V pattern, and fovea-disc angle (FDA) were observed.

RESULTS

The IOBT corrected the preoperative grade (+1.86 ± 0.53) of the mild-side IOOA to a postoperative grade (+0.07 ± 0.27; p < 0.001), and the severe-side IOOA was corrected from a grade of +3.14 ± 0.53 to a postoperative grade of +0.14 ± 0.36 by the IO recession (p < 0.001). The vertical deviation at distance in the primary position was decreased from 8.43 ± 4.05 PD preoperatively to 1.21 ± 1.48 PD postoperatively (p < 0.001). The mean V pattern was 25.00 ± 11.62 PD preoperatively and 3.18 ± 2.18 PD postoperatively (p < 0.001). The mean preoperative FDA on the side where IOBT was performed was -10.47 ± 5.85 degrees, and the postoperative FDA was -7.82 ± 6.42 degrees (p = 0.023). The mean FDA on the side with IO recession was -11.05 ± 5.14 degrees before surgery and -6.09 ± 4.52 degrees after surgery (p = 0.001). The overall success rate was 71.4% (10 of 14).

CONCLUSIONS

IOBT combined with IO recession is effective and safe in eliminating hypertropia, V pattern, and extorsion with bilateral asymmetric IOOA.

摘要

目的

评估下斜肌腹移位（IOBT）联合下斜肌（IO）后退术治疗双侧非对称下斜肌亢进（IOOA）的疗效。

方法

回顾性研究。回顾性分析 14 例双侧非对称 IOOA 患者中，10 例在轻侧行 IOBT，10 例在重侧行 IO 后退术的资料。观察主要手术结果，包括对 IOOA、斜视、水平偏斜、V 征和黄斑中心凹-视盘距离（FDA）的矫正。

结果

IOBT 将轻侧术前（+1.86±0.53）的 IOOA 矫正为术后（+0.07±0.27；p＜0.001），IO 后退术将重侧术前（+3.14±0.53）的 IOOA 矫正为术后（+0.14±0.36；p＜0.001）。第一眼位垂直偏斜距离从术前的 8.43±4.05 PD 减少到术后的 1.21±1.48 PD（p＜0.001）。平均 V 征术前为 25.00±11.62 PD，术后为 3.18±2.18 PD（p＜0.001）。IOBT 侧术前平均 FDA 为-10.47±5.85 度，术后为-7.82±6.42 度（p=0.023）。IO 后退术侧术前平均 FDA 为-11.05±5.14 度，术后为-6.09±4.52 度（p=0.001）。总体成功率为 71.4%（10/14）。