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[麻痹性斜视的治疗]

[Treatment of paralytic strabismus].

作者信息

Maruo T

机构信息

Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 1994 Dec;98(12):1161-79.

PMID:7832064
Abstract
  1. Cases of strabismus combined with abnormalities in ocular movement were divided into three groups: paralytic nonconcomitant strabismus, special forms of strabismus, and paralytic concomitant strabismus. 977 cases of surgery for paralytic nonconcomitant strabismus were analyzed. 2) 109 cases of surgery for paralytic esotropia due to abducens palsy were performed. In cases of complete paralysis, a transposition of the vertical rectus muscle was indicated. In cases of incomplete paralysis, a resection of the lateral rectus muscle was indicated. On the basis of these indications, the same results could be achieved, and when a recession of the medial rectus muscle was concurrently performed the results were improved. 3) In oculomotor palsy, 138 cases of surgery for paralytic exotropia were performed. In cases of complete paralysis, a transposition of the superior oblique muscle was indicated. In cases of incomplete paralysis, a resection of the medial rectus muscle was indicated. On the basis of these indications, the same results could be achieved, and when a recession of the lateral rectus muscle was concurrently performed the results were improved. 4) 570 cases of surgery for superior oblique muscle palsy were performed. In cases of vertical deviation, a weakening operation on the inferior oblique muscle, the superior rectus muscle of the affected eye, and the inferior rectus muscle of the sound eye were indicated. In cases of torsional deviation, good results were obtained through an advancement of the anterior part of the superior oblique muscle and a resection of the superior oblique muscle. 5) Statistics concerning cure based on the standards for cure employed by the Japanese Association of Strabismus and Amblyopia, or from the point of view of cosmetic cure were: 85% for paralytic esotropia and superior oblique muscle palsy, 82% satisfactory for incomplete paralysis of the oculomotor nerve within paralytic exotropia, and 61% relatively unsatisfactory for complete paralysis of the oculomotor nerve within paralytic exotropia. 6) The results of 216 cases examined after period of four years or longer were: cases where a one-month postoperative cure or cosmetic cure was maintained over this period were 90% of superior oblique muscle palsy cases, 79% of paralytic esotropia, and 59% of paralytic exotropia. Paralytic exotropia showed poor results. The surgical methods were muscle transposition in cases of horizontal muscle surgery and surgery of the oblique muscles in cases of vertical muscle surgery. 7) Through the Turn-Amplitude Analysis of the amounts of EMG interference patterns in the extraocular muscle, neuropathy was classified as either complete or incomplete.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
  1. 斜视合并眼球运动异常的病例分为三组:麻痹性非共同性斜视、特殊形式的斜视和麻痹性共同性斜视。对977例麻痹性非共同性斜视手术病例进行了分析。2) 对109例因外展神经麻痹导致的麻痹性内斜视进行了手术。在完全麻痹的病例中,宜行垂直直肌移位术。在不完全麻痹的病例中,宜行外直肌切除术。基于这些指征,可取得相同的效果,若同时行内直肌后徙术,效果会更佳。3) 在动眼神经麻痹中,对138例麻痹性外斜视进行了手术。在完全麻痹的病例中,宜行上斜肌移位术。在不完全麻痹的病例中,宜行内直肌切除术。基于这些指征,可取得相同的效果,若同时行外直肌后徙术,效果会更佳。4) 对570例上斜肌麻痹进行了手术。在垂直偏斜的病例中,宜对患眼下斜肌、患眼上直肌及健眼下直肌进行减弱手术。在旋转偏斜的病例中,通过上斜肌前部前徙术及上斜肌切除术取得了良好效果。5) 根据日本斜视与弱视协会采用的治愈标准或从美容治愈的角度统计的治愈率为:麻痹性内斜视和上斜肌麻痹为85%,麻痹性外斜视中动眼神经不完全麻痹的满意率为82%,动眼神经完全麻痹的满意率为61%,相对不满意。6) 对216例术后四年或更长时间进行检查的结果为:在此期间术后一个月维持治愈或美容治愈的病例,上斜肌麻痹病例占90%,麻痹性内斜视病例占79%,麻痹性外斜视病例占59%。麻痹性外斜视效果较差。水平肌手术的方法是肌肉移位,垂直肌手术的方法是斜肌手术。7) 通过对眼外肌肌电图干扰模式量的转动幅度分析,将神经病变分为完全性或不完全性。(摘要截取自400字)

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