2种下斜肌暴露法的比较分析

Comparison of two methods of inferior oblique muscle exposure

目的探讨减少下斜肌暴露术并发症的方法。方法下斜肌功能亢进97眼(83例),分为2组,均接受下斜肌转位术,第1组(43眼)下斜肌暴露采用传统法,第2组(54眼)采用改良法。观察术中和术后并发症,随访6～18个月。结果第1组、第2组出血分别为11眼(25.58%)和4眼(7.40%),下斜肌残留分别为8眼(18.6%)和3眼(5.56%),差异具有显著意义(P<0.01)。第1组眶脂肪脱出1眼,第2组持续性下斜肌功能亢进1眼,2组均无粘连综合征发生。结论下斜肌暴露采用改良法,简单、安全和有效,易于初学者掌握。

Objective To find a method which can reduce the complications in the exposure of inferior oblique muscle. Methods Ninty-seven eyes （83 cases） with inferior oblique muscle hyperactivity,which underwent inferior oblique muscle transposition,were divided into two groups. In the first group（43 eyes）, the inferior oblique muscle exposure was treated with traditional method, and the second group（54 eyes）with improved method. The complications were observed in operation and postoperation.All eyes were followed up from 6 to 18 months. Results Bleeding occurred in the first and the second group were 11 eyes（25.58%）and 4 eyes（7.40%）, and partial inferior oblique muscle remained 8 eyes（18.86%）and 3 eyes（5.56% ） respectively. There were significant difference of complications between two groups（P〈0.01）. The orbital fat of 1 eye prolapsed in the first group. Persistent inferior oblique muscle hyperactivity of 1 eye took place in the second group.No adherence syndrome occurred in two groups. Conclusion The improved method of inferior oblique muscle exposure is simple, safe and effective, especially for the beginners.