Ohmi G, Fujikado T, Ohji M, Saito Y, Tano Y
Department of Ophthalmology, Osaka University Medical School, Japan.
Graefes Arch Clin Exp Ophthalmol. 1997 Jan;235(1):1-4. doi: 10.1007/BF01007829.
Horizontal transposition of the vertical rectus muscles has been performed for treatment of excyclotropia associated with congenital absence of the superior oblique, and for residual excyclotropia after the Harada-Ito operation. However, the amount of excyclotropia that can be corrected and whether this technique alters the vertical muscle balance is not well known. We report the surgical results of three patients with pure excyclotropia who underwent unilateral one-half tendon width horizontal transpositions of vertical rectus muscles.
A one-half muscle width temporal transposition of the superior rectus and nasal transposition of the inferior rectus muscles of one eye was performed in three patients with pure excyclotropia and no associated hypertropia. All three had intermittent torsional diplopia before surgery.
Postoperatively, excyclotropia decreased significantly in all fields of gaze, with 8 degrees of reduction by synoptophore and 12.3 degrees of reduction by fundus photography on average. There was no associated vertical or horizontal deviation. All three patients reported improvements of cyclofusion.
One-half muscle width temporal transposition of the superior rectus and nasal transposition of the inferior rectus muscles was effective in ameliorating excyclotropia and corrected subjective complaints without altering vertical muscle balance.
垂直直肌水平移位术已用于治疗与先天性上斜肌缺如相关的外旋转斜视，以及Harada-Ito手术后残留的外旋转斜视。然而，可矫正的外旋转斜视量以及该技术是否会改变垂直肌平衡尚不清楚。我们报告了3例单纯外旋转斜视患者接受单眼垂直直肌半肌腱宽度水平移位术的手术结果。
对3例单纯外旋转斜视且无相关上斜视的患者，进行一眼上直肌半肌宽度颞侧移位及下直肌鼻侧移位。3例患者术前均有间歇性扭转性复视。
术后，所有注视视野中外旋转斜视均显著降低，平均同视机检查降低8度，眼底照相降低12.3度。无相关垂直或水平偏斜。所有3例患者均报告旋转融合功能改善。
上直肌半肌宽度颞侧移位及下直肌鼻侧移位术在改善外旋转斜视及纠正主观症状方面有效，且未改变垂直肌平衡。
