先天性上斜肌麻痹的手术方式分析

Surgical analysis of the congenital superior oblique paralysis

目的:探讨先天性上斜肌麻痹的手术治疗方法。方法:对我院2004-10/2005-02收治的39例先天性上斜肌麻痹患者,根据患眼的下斜肌功能亢进程度和垂直斜度大小选择下斜肌后徙、下斜肌切断并部分切除、下斜肌前转位、或联合对侧眼上直肌、下直肌手术。结果:治愈28例(72%),好转10例(26%),无效1例(2%)。结论:先天性上斜肌麻痹的手术方式按减弱直接拮抗肌和配偶肌,加强麻痹肌和间接拮抗肌的原则进行,根据患者下斜肌功能亢进程度和垂直斜视度大小选择不同术式可获得良好的效果。

AIM： To discuss the surgery methods of the congenital superior oblique paralysis. METHODS： We chose 39 patients （42 eyes） with congenital superior oblique paralysis treated by us from October, 2004 to February, 2005. According to the degree of the overaction of superior oblique muscle and the extension of vertical strabismus, we performed inferior oblique muscle recession, myotomy, anteriorization, associated with the surgery of the contralateral superior rectus muscle or inferior rectus muscle. RESULTS： Twenty-eight cases were cured （72%）, 10 cases were improved （26%）, and one case received no effectiveness （2%）. CONCLUSION： The surgery of congenital superior oblique paralysis can be performed to weaken direct antagonist and yoke muscles, or strengthen palsy muscle and controlateral antagonist. It can obtain ideal effects if performed according to the excess degree of the superior oblique muscle and the degree of the vertical strabismus.