下斜肌后徙转位术后的安全性分析

Elevation deficiency after anterior transposition of inferior oblique muscle

目的 通过比较下斜肌（Inferioroblique IO）后徙术与IO后徙转位术,术后至少3年的疗效,评价IO后徙转位术的安全性.方法 比较IO后徙术组（22例33只眼）和IO后徙转位术组（27例33只眼）病例手术后IO运动程度和眼球上转程度,分析可能的相关因素.结果 （1）IO后徙转位术组左右眼手术后远期IO运动程度、眼球上转程度均明显低于IO后徙术组,差别有统计学意义,P＜0.001.（2）术后IO运动程度不足与手术年龄、有无弱视、屈光状态、是否同时行水平斜视手术、术前IO功能亢进程度和斜视度均无关.（3）IO后徙转位术组术后远期IO运动程度、眼球上转程度均低于近期（1周至1个月）,有明显统计学差异,P＜0.001.术后中期（3～6个月）与远期IO运动程度、眼球上转程度之间差异无统计学意义,P＞0.05.结论 IO后徙转位术式存在术后眼球上转功能不足,IO功能不足的缺点,并且在术后持续存在.

Objective Through compared the effect of anterior transposition and recession of inferior oblique （IO）, to study the security of anterior transposition of the inferior oblique. Methods A retrospective case control study. Compare the ocular elevation and the IO function after anterior transposition versus reces sion of the IO. Results The comparison of elevation and the IO function of anterior transposition versus recession of IO group yielded significant difference at long-term follow-up, P 〈0.001. The deficiency of IO function after surgery had no relationship with the age of surgery, amblyopia, refraction error, accompany horizontal strabismus surgery, the degree of IOOA and oblique angle. In anterior transposition of IO group, the ocular elevation and the IO function had significant difference at long term follow-up versus early follow-up, P 〈0.001, but had no difference at long term follow-up versus intermediate follow-up. Conclusions Anterior transposition of the IO may cause a limitation of elevation and the function oflO deficiency, which may exist continually.