Seawright A A, Gole G A
Royal Children's Hospital, Brisbane, Queensland, Australia.
J Pediatr Ophthalmol Strabismus. 1998 Jan-Feb;35(1):33-7. doi: 10.3928/0191-3913-19980101-11.
To report the results of treatment of a series of patients with superior oblique overaction using the superior oblique silicone tendon-expander technique.
A chart review of 17 patients with superior oblique overaction who had a total of 26 silicone tendon-expander procedures was conducted.
Mean preoperative degree of superior oblique overaction was +2.7. 92% of eyes had mild (+1) or no residual overaction at last postoperative assessment (follow-up range: 6 to 59 months). Of 15 patients with preoperative A-pattern of 10 prism diopter (delta) or more, only two patients (13%) had A-pattern of 10 delta or more at last assessment. Of 13 patients with preoperative hypotropia in primary position, five patients (38%) had no vertical deviation in primary position, and seven patients (54%) had persistent, but less vertical deviation in primary position at last assessment (mean reduced from 11 delta to 4 delta). No patient manifested superior oblique palsy at their last postoperative assessment.
We believe that the superior oblique tendon-expander technique should be strongly considered for the treatment of superior oblique overaction associated with A-pattern or hypotropia in primary position, because it has a high success rate and a low incidence of postoperative complications. Consecutive superior oblique underaction did not occur in this series.
报告采用上斜肌硅胶腱扩张技术治疗一系列上斜肌亢进患者的结果。
对17例上斜肌亢进患者进行病历回顾，这些患者共接受了26次硅胶腱扩张手术。
术前上斜肌亢进的平均度数为+2.7。在最后一次术后评估（随访时间为6至59个月）时，92%的患眼有轻度（+1）或无残余亢进。术前A征为10棱镜度（Δ）或更高的15例患者中，在最后一次评估时只有2例患者（13%）的A征为10Δ或更高。术前第一眼位存在下斜视的13例患者中，5例患者（38%）在最后一次评估时第一眼位无垂直斜视，7例患者（54%）第一眼位存在持续但程度减轻的垂直斜视（平均从11Δ降至4Δ）。在最后一次术后评估中，没有患者出现上斜肌麻痹。
我们认为，对于治疗与A征或第一眼位下斜视相关的上斜肌亢进，应强烈考虑采用上斜肌腱扩张技术，因为其成功率高且术后并发症发生率低。本系列未发生连续性上斜肌功能不足。
