摘要
目的 探讨先天性双上转肌麻痹的临床特征和有效的手术治疗方法。方法 根据病情对 11例先天性双上转肌麻痹患者行不同手术治疗 ,观察手术前后眼位、斜视度数及临床特征的变化。结果 11例先天性双上转肌麻痹患者中 ,10例患眼下斜 ,1例健眼上斜。患眼向上、内上及外上活动受限 ,且合并假性上睑下垂。 10例以健眼注视的患者中 ,2例行患眼下直肌后退 ,8例行患眼上斜肌切断及下直肌后退术 ,其中 2例因第 1次手术量不足 ,术后 6个月再行健眼上直肌后退术。 7例合并外斜视患者同时行外直肌后退术 (单眼 5例 ,双眼 2例 )。 1例以患眼注视的患者行健眼下斜肌切断及上直肌后退术。 9例患者第一眼位斜视完全矫正 ,2例斜视症状明显改善。 7例合并外斜视者症状全部消失。患眼下斜肌和上直肌功能均无改善。上睑下垂症状 9例患者消失 ,1例患者明显改善 ,1例患者无改善。结论 先天性双上转肌麻痹是临床较为少见的一种眼球运动障碍性疾病 ,上直肌和下斜肌同时麻痹是其发病的主要临床特征 ;其有效的手术治疗方法是垂直直肌后退术和上斜肌切断术。
Objective To investigate the clinical features of congenital ocular elevator muscle palsy and to evaluate the efficacy of surgical treatment. Methods Pre- and post-operative eye position, superior rectus muscle and inferior obli que muscle function, clinical features were examined and analyzed in 11 patients wit h congenital double elevator palsy of ocular muscles. Results When fixated with the nonparetic eye, ten of 11 patients showed hypotropia and pseudoblepharoptosis in the primary position; One of 11 patients fixated with the paretic eye and showed hypotropia in the primary position. All cases were a monocular elevation deficie ncy in abduction and adduction, and showed pseudoblepharoptosis. In ten patients fixate d with the nonparetic eye, two of 10 were undergone inferior rectus recession on p aretic eyes; six of 10 were undergone inferior rectus recession and superior oblique tenectomy on paretic eyes; two of 10 were applied inferior rectus recession and superior oblique tenectomy on paretic eyes, superior rectus recession was perfor med on healthy eyes in six months postoperation. The patient fixated with the pareti c eye were undergone superior rectus recession and inferior oblique tenectomy on heal thy eyes. Seven patients with exotropia had lateral rectus muscle surgery performed at the time of their vertical operation. Strabismus were complete corrected in 81.8 % ( 9/11) of patients in our study and 18.2%(2/11) of patients were partial corrected. The functions of superior rectus muscle and inferior oblique muscle were not correct ed. Nine patients showed complete correction of the psuedoptosis, one patient showed partial correction of the psuedoptosis, one patient did not showed any improveme nt of the pseudoptosis. Conclusions We conclude that superior rectus muscle and inferior oblique muscle insufficiency are the primary factors in the etiology of congenit al double ocular elevator palsy. Vertical rectus recession and superior oblique ten ectomy on paretic eyes is an effective way of
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2004年第10期652-654,共3页
Chinese Journal of Ophthalmology
