Sharma P, Halder M, Prakash P
Dr. R.P. Centre for Ophthalmic Sciences, AIIMS, New Delhi.
Indian J Ophthalmol. 1997 Mar;45(1):31-5.
The role of torsion in the aetiopathogenesis of A-V phenomena has not been sufficiently emphasized. The success of vertical displacement of horizontal recti in correction of A or V has not been attributed to torsional changes. To evaluate this aspect, 21 cases of A or V phenomena were subjected to monocular recession-resection procedure with vertical shifting. Preoperative and postoperative torsional changes were evaluated on synoptophore (subjective torsion), and confirmed by fundus photography (objective torsion). Intorsion with A phenomenon was seen preoperatively in 5 of 8 cases which increased after surgery and was seen postoperatively in the other 3 cases also. Extorsion was observed in 5 of 13 cases pre operatively in 'V' phenomenon, but the changes in extorsion after surgery were less dramatic than those in intorsion. The oblique overactions were reduced in cases where they were present. Correction of A-V phenomena by torsion induced by vertical shifting of horizontal recti muscles is proposed, highlighting the role of torsion in A-V phenomena.
扭转在A-V现象的病因发病机制中的作用尚未得到充分重视。水平直肌垂直移位矫正A征或V征的成功尚未归因于扭转变化。为评估这一方面，对21例A征或V征患者进行了伴有垂直移位的单眼后徙-切除术。术前和术后的扭转变化通过同视机进行评估（主观扭转），并通过眼底照相术进行确认（客观扭转）。8例A征患者中有5例术前出现内旋，术后增加，另外3例术后也出现内旋。13例V征患者中有5例术前出现外旋，但术后外旋的变化不如内旋明显。存在斜肌亢进的病例中，斜肌亢进有所减轻。提出通过水平直肌垂直移位诱导的扭转来矫正A-V现象，突出了扭转在A-V现象中的作用。
