外直肌悬吊后徙术矫治大角度外斜视

Suspending and recession of the lateral rectus of large angle strabismus.

目的探讨矫治大角度外斜视在外直肌超常量徙后时,肌止端后移、肌肉缝线悬吊的效果。方法对65例大角度外斜视在做外直肌徙后时,将肌肉缝线平行外直肌上下缘于肌止端后5 mm处巩膜浅层穿出,测量肌止点与拟行肌肉缝线结扎点后肌肉断端的距离是否与术前拟行后徙量相符,确定后结扎缝线。例如后徙量为11 mm,则肌肉缝线于肌止点后5 mm处巩膜穿出,悬吊量为6 mm时结扎缝线,形如吊床状。结果65例有1例残留5°外斜,其余64例均达到正常眼位。结论采用悬吊方法进行外直肌超常量徒后,既减少了眼外肌与眼球筋膜的大范围粘连及手术操作困难带来的巩膜意外损伤,又达到了矫治大角度外斜视的目的。

Objective To investigate the effect for lateral muscle suspending and recession for large angle strabismus. Methods In 65 patients suffering from large angle exotropia . The suture passed through out the sclera＇ s shallow layer at the back edge of the lateral rectus＇ s end, and should be parallel with the lateral rectus＇ fringes. Measured the distance between the lateral rectus＇ end and the planned ligature point equaled to the planed recessed length, then tied the suture. Results In 65 patients, only one left 5° strabismus, Conclusion The suspension and lateral rectus＇ recession is effective for large angle exotropia.