Taylor R H, Kraft S P
Department of Ophthalmology, Hospital for Sick Children, Toronto, Ontario, Canada.
Ophthalmology. 1997 Mar;104(3):415-8. doi: 10.1016/s0161-6420(97)30299-1.
The authors describe the clinical findings, results of preoperative radiologic studies, and results of surgery in a boy with congenital unilateral inferior rectus aplasia.
A 2-year-old boy is described who presented with a significant anomalous head posture, a large incomitant vertical deviation with marked deficit of depression of the left eye, and positive head-tilt test results. Preoperative magnetic resonance imaging (MRI) defined an absent inferior rectus muscle; computed tomography showed no evidence of a craniofacial syndrome. Full tendon inferior transposition of the horizontal rectus muscles was carried out on the affected eye.
The compensatory head position was eliminated. The infraduction improved. The patient had a small left hypotropia after the healing phase.
To the authors' knowledge, this case is the first that used MRI to confirm preoperatively the isolated absence of an inferior rectus muscle. The MRI allowed effective surgical planning to correct the congenital abnormality.
作者描述了一名患有先天性单侧下直肌发育不全男孩的临床发现、术前影像学检查结果及手术结果。
描述了一名2岁男孩，其表现为明显异常的头位、较大的非共同性垂直斜视，左眼明显下转不足，以及头倾试验阳性。术前磁共振成像（MRI）显示下直肌缺如；计算机断层扫描未显示颅面综合征的证据。对患眼进行了水平直肌完全肌腱下转位手术。
代偿性头位消失。下转功能改善。愈合期后患者左眼有轻度下斜视。
据作者所知，该病例是首例术前使用MRI证实孤立性下直肌缺如的病例。MRI有助于制定有效的手术方案以纠正先天性异常。
