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[摘要]
目的:探讨先天性单侧上斜肌麻痹的手术治疗方法。
方法:本研究回顾分析对68例先天性单侧上斜肌麻痹患者,根据患眼的下斜肌功能亢进程度和原在位垂直斜度大小选择下斜肌切断并部分切除、下斜肌切断并前转位、下斜肌部分切除联合对侧眼下直肌或同侧眼直肌手术。伴有水平斜视者按水平斜视矫正原则一期或分期手术矫正。
结果:治愈58例,治愈率85.3%,好转7例,好转率10.3%,无效3例,无效率4.4%。
结论:根据下斜肌亢进程度、垂直斜视度及水平斜度选择不同手术方式,通过一期或分期手术,可有效获得较高治愈率。
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[Abstract]
AIM: To investigate the surgical treatment of thecongenital superior oblique muscle paralysis.
METHODS:The 68 cases of congenital superior oblique muscle paralysis were reviewed and analyzed. According to the degrees of the overaction of inferior oblique muscle and the extension of vertical deviation, we performed three different surgeries: inferior oblique muscle myotomy, inferior oblique muscle anterior transposition and inferior oblique muscle anterior transposition plus superior rectus muscle shortening or inferior rectus muscle recession. Based on the correct principles of horizontal strabismus, the patients were successfully treated if they also have horizontal strabismus problems.
RESULTS:Totally 58 cases were cured(85.3%), 7 cases were improved(10.3%)and 3 cases had no effective improvement(4.4%).
CONCLUSION: According to degree of the overaction of inferior oblique muscle, the extension of vertical and horizontal deviation, reasonable choice of surgical manners might increase cure rate of the congenital superior oblique muscle paralysis. The most patients obtained satisfactory results after one stage or multiple surgeries.
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