增强型下斜肌前转位联合部分肌肉切除术治疗下斜肌功能亢进的疗效评价

Evaluation on the anterior transposition of the inferior oblique muscle with and without resection for the inferior oblique muscle overreaction

[目的]对比观察标准下斜肌前转位术和下斜肌前转位联合部分切除术的临床疗效。[方法]下斜肌功能亢进的患者44例(60只眼),随机分为两组,分别接受标准下斜肌前转位术和下斜肌前转位联合部分切除术,观察对比术后第1周和术后2个月的眼球运动状况和垂直斜视度变化。[结果]标准下斜肌前转位术组术后第1周有2只眼下斜肌功能为+2级,4只眼下斜肌功能为+1级;术后2个月有2只眼下斜肌功能为+2级,5只眼下斜肌功能为+1级。下斜肌前转位联合部分切除术组术后第1周有1只眼下斜肌功能为+2级,5只眼下斜肌功能为+1级;术后2个月有2只眼下斜肌功能为+2级,5只眼下斜肌功能为+1级。两组对比差异无显著性意义。标准下斜肌前转位术组术后第1周第一眼位垂直斜视度平均为3.8±2.4△;术后2个月平均为4.4±3.9△。下斜肌前转位联合部分切除术组术后第1周第一眼位垂直斜视度平均为3.5±3.1△;术后2个月平均为4.1±3.3△。两组对比差异无显著性意义。[结论]下斜肌前转位联合部分切除术较标准下斜肌前转位术并没有显著增加手术效果。

[ Objective] This work is to estimate the clinical effect of anterior transposition of the inferior oblique muscle （ATIO） with and without resection in the treatment of inferior oblique muscle overreaction （IOOA）. [ Methods] Forty - four patients （60 eyes） with IOOA were divided into two groups randomly and undertook ATIO with and without an 8 - mm resection. The vertical deviation degree in primary position and the eyeball motility were recorded and evaluated. [ Results ] In the standard group, 4 cases revealed ＋ 1 and 2 cases revealed ＋ 2 IOOA 1 week post - surgery, 5 cases revealed ＋ 1 and 2 cases revealed ＋ 2 IOOA 2 months post - surgery. In the inferior oblique muscle resection group, 5 cases revealed ＋ 1 and 1 case revealed ＋ 2 IOOA 1 week post - surgery, 5 cases revealed ＋ 1 and 2 cases revealed ＋ 2 IOOA 2 months post - surgery. There were no significant differences between these two groups. The average vertical deviation degree in primary position was 3.8 ± 2.4^△ 1 week and 4.4 ± 3.9^△2 months post - surgery in the standard group. In the resection group, they were 3.5 ± 3.1^△ and 4.1 ± 3.3^△ respectively with no significant difference. [ Conclusion] An 8 -mm resection with the standard ATIO has no advantage to improve the surgery outcome of IOOA.