直肌边切术在先天性眼球震颤治疗中的疗效观察

Clinical observation of tendotomy for the treatment of congenital nystagmus

目的探讨治疗先天性眼球震颤的简捷、有效的手术方法.方法对21例年龄在7～12岁的先天性眼球震颤患者,采用改良的Parks手术方法,即在Parks手术方法的基础上采用直肌边切术代替Parks法中的直肌后退,而Parks法中的直肌缩短仍保持不变.结果15例(71.43%)患者相对静止眼位移至正前方,正前方眼震基本消失,6例(28.57%)眼震明显减轻,正前方为低幅低频震颤,视力提高2～5行;18例(85.71%)代偿头位基本消失,3例(14.29%)明显改善.16例术后随访2年,其中8例术后有轻度回退现象,6周后稳定者7例,经过2年随访,情况稳定者15例.经1～2年随访,18例效果满意.结论该术式效果肯定,手术操作简捷.手术因不需缝合巩膜,故不会有发生巩膜穿孔的危险,提高了手术的安全性.

Objective To investigate the effectiveness of rectus marginal myotomy for congenital nystagmus. Methods Twenty-one cases with congenital nystagmus received modified parks operation. On the basis of Parks, rectus marginal myotomy is adopted instead of recession in Parks. Results The zero zone of 15 cases（71.34% ） was moved forward to the normal place,and the nystagmus in the normal place almost disappeared. 6 cases（28.57% ） had a reduction of nystagmus,and their vision was remarkable improved. The compensatory head position was disappeared in 18 cases （85.71%） and attenuated in 3 cases and maintained stable in 15 cases during the 2-year follow-up. A satisfactory effectiveness was gotten in 18 cases after 2 years.Conclusion Modified Parks surgery is a favorable alternation for congenital nystagmus.