Barsoum-Homsy M
Can J Ophthalmol. 1981 Oct;16(4):181-6.
Because of the clinical observation that in patients with congenital esotropia the medial rectus is inserted closer to the limbus than we have classically been taught, the distance between the medial rectus insertion site and the limbus was measured at the time of corrective surgery in 26 infants under 1 year of age with congenital esotropia. The distance in the 52 eyes was found to vary between 3.0 and 5.5 mm (mean 4.5 mm; standard deviation 0.57 mm). Of the 25 patients available for follow-up assessment 8 required another operation because of a residual esodeviation greater than 10 prism diopters, yet in some of the 8 a maximum recession of the muscle (6 mm from the insertion site) had been done. It is proposed that the maximum recession be increased to 11.5 mm from the limbus. This might reduce the risk of undercorrection, especially in patients with an esodeviation above 70 prism diopters. Further studies need to be done to evaluate the normal insertion sites of the extraocular muscles in the different pediatric age groups.
由于临床观察发现，先天性内斜视患者的内直肌附着点比我们传统所学的更靠近角膜缘，因此在26例1岁以下先天性内斜视婴儿的矫正手术中测量了内直肌附着点与角膜缘之间的距离。发现52只眼中该距离在3.0至5.5毫米之间变化（平均4.5毫米；标准差0.57毫米）。在可供随访评估的25例患者中，8例因残余内斜视大于10棱镜度而需要再次手术，然而在这8例中的一些患者中，肌肉已进行了最大程度的后徙（从附着点后徙6毫米）。建议将最大后徙距离增加到距角膜缘11.5毫米。这可能会降低矫正不足的风险，尤其是对于内斜视超过70棱镜度的患者。需要进一步研究以评估不同儿童年龄组眼外肌的正常附着点。
