Gobin M H
Trans Ophthalmol Soc U K (1962). 1981;101 (Pt 2):258-63.
Our surgical treatment of the A and V phenomena consists of a systematic combination of oblique and horizontal muscle surgery. The oblique muscles are desagittalized: the plane of action of the muscle is displaced forwards so that its angle with the visual axis enlarges. The vertical action of the oblique muscle is thus reduced in favour of the torsional action. This desagittalization is always performed bilaterally and combined with a bilateral recession of a rectus muscle: the medial rectus muscles in cases of esotropia and the lateral rectus muscles in cases of exotropia. A real vertical deviation (RVD), if present, is treated by asymmetrical oblique muscle surgery or by the weakening of a vertical rectus muscle. In cases of under- or overcorrection a remaining diagonal and vertical deviation is carefully searched for and dealt with. In addition, a horizontal undercorrection is treated by placing a secondary loop on the already recessed medial rectus muscle, and a horizontal overcorrection is treated by weakening both lateral rectus muscles.
我们对A和V现象的手术治疗包括斜肌手术和水平肌手术的系统联合。斜肌进行矢状移位：肌肉的作用平面向前移位，使其与视轴的夹角增大。斜肌的垂直作用因此减弱，有利于扭转作用。这种矢状移位总是双侧进行，并与一条直肌的双侧后徙联合：内斜视病例中为内直肌，外斜视病例中为外直肌。如果存在真正的垂直斜视（RVD），则通过不对称斜肌手术或垂直直肌减弱术进行治疗。在欠矫或过矫的病例中，仔细查找并处理剩余的斜向和垂直斜视。此外，水平欠矫通过在已经后徙的内直肌上放置一个次级袢进行治疗，水平过矫通过减弱双侧外直肌进行治疗。
