内外直肌后徙联合Y形分开术治疗Duane眼球后退综合征

Treatment of Duane＇s retraction syndrome by recession of medial and lateral rectus muscles combined with Y-spfitting procedure

目的探讨内外直肌后徙联合Y形分开术治疗Duane眼球后退综合征的新型手术方法和效果。方法对8例Duane眼球后退综合征患者行手术治疗。7例正向型Duane眼球后退综合征患者中，6例行内外直肌后徙联合Y形分开术，1例行外直肌后徙联合Y形分开术；1例反向性Duane眼球后退综合征患者行双眼内外直肌后徙联合双眼内直肌Y形分开术。术后随访1～12个月，观察患者的眼位、眼球运动及代偿头位变化情况。结果患者代偿头位、急速上转或下转消失；眼球后退及睑裂变小得到改善；术后6例眼位为正位，2例仍有残余斜视。结论内外直肌后徙联合Y形分开术可有效地治疗Duane眼球后退综合征，达到矫正斜视、改正头位、消除眼球后退的目的。（中华眼科杂志．2007。43：972-976）

Objective To investigate the new surgical method and effect of treatment of Duane＇s retraction syndrome by recession of medial and lateral rectus muscles combined with Y-splitting procedure. Methods Eight patients with Duane retraction syndrome underwent surgery. Among seven cases of normal direction Duane＇s retraction syndrome, Six patients were performed recession of medial and lateral rectus muscles with Y-splitting of lateral rectus muscle, one patient was performed recession and Y-splitting of lateral rectus muscle. One patient with inverse Duane＇s retraction syndrome was performed bilateral recession of medial and lateral rectus muscles combined with Y-splitting of both medial rectus muscles. All patients were followed up 1 to 12 months. Ocular alignment, ocular motility and change of compensatory head posture were evaluated. Results The compensatory head posture, upshoot or downshoot were eliminated. Globe retraction and narrowing of palpebral fissure got improved. Postoperative ocular alignment of 6 cases achieved orthophoric, with 2 cases of residual strabismus. Conclusions Recession of medial and lateral rectus muscles combined with Y-splitting procedure is an effective method for treatment of Duane＇s retraction syndrome ,aiming at correction of ocular deviation and head posture and elimination of globe retraction. （Chin J Ophthalmol , 2007,43：972-976 ）