后天性固定性内斜视的手术设计和疗效分析

Design and Analysis of Curative Effect of Operation for Acquired Esotropia Fixus

目的通过观察后天性固定性内斜视的不同手术方法的临床疗效,探讨合适的手术设计。方法2007年9月~2012年12月共收治固定性内斜视7例(12眼),根据患者手术前的专科检查情况,2例(3眼)采用内直肌后徙联合外直肌缩短术,2例(3眼)采用显微镜下内直肌后徙联合上下直肌部分移位术,3例(6眼)采用硅胶带外眦眶骨膜悬吊术,观察手术后眼位和眼球运动情况。结果术后眼位基本正,较术前有明显改善。眼球运动检查,5只眼球有轻度转动,7只眼运动明显受限。随访6个月~2年,4例眼位基本正位(小于±10PD),2例欠矫,1例过矫。结论后天性固定性内斜视临床表现较为复杂,术前应完善各项检查,选择合适的手术方式,仍可获得比较满意的手术效果。

Objective To observe the acquired fixed esotropia clinical ef icacy of dif erent surgical methods to explore the appropriate surgical designs.Methods From September 2007 to December 2012 were treated fixed esotropia seven cases(12 eyes),according to the patient before surgery specialist inspection,two cases(3 eyes)using the medial rectus recession combined with lateral rectus muscle shortening,2 cases(3 eyes)using a microscope medial rectus recession combined with the upper rectus and lower rectus transposition,three cases(6 eyes)using silicone band suspension was observed after surgery eye position and eye movement.Results The postoperative eye position basically positive,compared with preoperative showed significant improvement.Eye movement examination,5 eyes can rotate slightly,7 eyes movement was limited.Fol owed up for 6 months to 2 years,4 cases of eye position basic anteroposterior(less than±10PD),2 cases of less correct,1 case of over correct.Conclusion Acquired fixed esotropia more complex clinical presentation,preoperative should improve the inspection,select the appropriate surgical method,you can stil obtain satisfactory outcome.