直肌移位术治疗麻痹性内斜视的观察

Rectus shift in treatment of paralytic esotropia

目的观察上、下直肌移位术治疗麻痹性内斜视的手术效果。方法回顾分析从1995年5月至2006年5月采用上、下直肌移位联合内直肌后徙术治疗麻痹性内斜视45例（45眼）的手术效果。并依据上、下直肌移位的量分为1／3肌束移位量组和1／2肌束移位量组，两组内直肌后徙量均为7mm。患者术前检查斜视角及利用弧形视野计记录眼球外转幅度，术后随访1～3a，统计分析两组对内斜视的矫正度及眼球外转幅度。结果术后34例矫正至正位，欠矫11例，全部患者外转功能部分恢复，未发生眼并发症。上、下直肌1／3移位量与1／2移位量组对内斜的矫正度差异无显著性（P〉0．05），上、下直肌1／2移位量组眼球外转幅度好于1／3移位量组。结论上、下直肌移位术治疗麻痹性内斜视疗效良好，上、下直肌1／2与1／3移位量对斜视度矫正无明显影响。

Objective To observe the effect of rectus shift in treatment of paralytic esotropia. Methods 45 cases （45 eyes） of paralytic esotropia accepted rectus shift were analysed retrospectively. About 1/3 superior and inferior muscle bundle was shift in one group and About 1/2 muscle bundle shift in the other group. Both groups with 7mm retropulsion of internal rectus muscle. The follow up time was about 1 - 3 years, the angle of strabismus and extent of abversion before and after operation were compared. Results 34 cases got orthophoria and 11 cases were not correct enough, All cases got some abversion function and no complication occurred. No statistic difference of correction of paralytic esotropia between two group, but the extent of abversion in 1/2 muscle bundle shift group was better. Conclusions Rectus shift is an effective method for treatment of paralytic esotropia.