Tomaç S, Kalayci D, Hasiripi H
Ophthalmology Department, Ankara Numune Hospital, Ankara, Turkey.
Binocul Vis Strabismus Q. 1998;13(4):267-72.
To report a case in which strabismus surgery did not eliminate the abnormal head posture although it did improve the vertical strabismus; and to consider the causes of this situation.
The patient had a right eso-hypertropia and ocular torticollis to the left shoulder as a result of a right superior oblique mechanical deficiency, secondary to her craniosynostosis. A myectomy of the right inferior oblique muscle and a tucking procedure of the right superior oblique muscle were performed. Postoperatively, the abnormal head posture persisted, although strabismus surgery improved the vertical deviation. However, improvement of the abnormal head posture upon patching the deviated eye only indicated that the origin of the persistent abnormal head posture must be ocular. Further tests revealed that an anomalous retinal correspondence (ARC) with eccentric fixation was responsible.
In patients with ocular torticollis, ARC with eccentric fixation must be ruled out prior to surgery as these may negatively affect the outcome.
报告一例斜视手术虽改善了垂直斜视，但未消除异常头位的病例，并探讨出现这种情况的原因。
该患者因颅骨缝早闭继发右上斜肌机械性不足，导致右眼内上斜视及向左肩的眼性斜颈。行右眼下斜肌切除术及右上斜肌折叠术。术后，尽管斜视手术改善了垂直偏斜，但异常头位仍持续存在。然而，遮盖偏斜眼后异常头位改善仅表明持续异常头位的根源必定在眼部。进一步检查发现是伴有旁中心注视的异常视网膜对应（ARC）所致。
对于眼性斜颈患者，术前必须排除伴有旁中心注视的ARC，因为这些可能会对手术结果产生负面影响。
