不同下斜肌术式在V征治疗的临床观察

Effects of different inferior oblique surgical procedures in the treatment of V-pattern deviation

目的 对比观察下斜肌断腱术和下斜肌部分切除术在V征治疗中的效果.方法 取伴有下斜肌亢进的V征患者35例.使用三棱镜交替遮盖法测量视近时第一眼位及上下转25°时的水平斜视度.对下斜肌功能亢进程度进行分级.随机分为2组,分别行下斜肌断腱术和下斜肌部分切除术,观察术后3个月的上下转斜视度差值和下斜肌功能变化.结果 术后3个月时下斜肌断腱术组上下转斜视度差值平均为（5.6 4±5.4）△,下斜肌部分切除术组上下转斜视度差值平均为（4.7±4.3）△,两组相比无显著性差异（P〉0.05）.下斜肌断腱术组下斜肌功能＋2级2只眼,＋1级7只眼,0级21只眼.下斜肌部分切除术组下斜肌功能＋2级1只眼,＋1级5只眼,0级22只眼.两组相比无显著性差异（P〉0.05）.结论 下斜肌断腱术和下斜肌部分切除术都有效的解决了下斜肌亢进的V征问题,消除了垂直非共同性.

Objective To estimate the clinical effect of different inferior oblique surgical procedures in the treatment of V-pattern deviation.Methods Thirty-five patients with V-pattern deviation were divided into two groups randomly and undertook inferior oblique disinsertion or myectomy.The difference of deviation degree between up and down position and the inferior oblique function were recorded and evaluated.Results The average difference position was 5.6± 5.4△3 months post-surgery in the disinsertion group.This compared with 4.7± 4.3△in the myectomy group.There were no significant differences.In the disinsertion group, 2 cases revealed ＋2 inferior oblique muscle overaction （IOOA）, 7 cases revealed ＋1 and 21 cases revealed 0 IOOA 3 months post-surgery.In the myectomy group, 1 case revealed ＋2 IOOA, 5 cases revealed ＋1 and 22 cases revealed 0 IOOA 3 months post-surgery .There were no significant differences between two groups.Conclusions Inferior oblique disinsertion or myectomy both are effective treatment for V-pattern deviation.