下斜肌前置移位治疗伴有下斜肌亢进的分离性垂直偏斜

Anterior transposition of the inferior oblique muscle for dissociated vertical deviation associated with inferior oblique muscle overaction

目的:观察下斜肌前置移位治疗伴有下斜肌亢进的分离性垂直偏斜(dissociated vertical deviation,DVD)。方法:下斜肌前置移位于下直肌附着点颞侧前2mm或下直肌附着点颞侧成一直线处,同时矫正水平斜视。结果:患者8例11眼中,术前6眼DVD程度是1+,术后DVD消失;术前3眼DVD程度是2+,术后2眼垂直斜视消失,1眼DVD程度为1+;术前2眼DVD程度是3+,术后1眼DVD程度为1+,1眼为2+。所有患者下斜肌均不亢进。结论:下斜肌前置移位是治疗伴有下斜肌亢进的DVD的有效方式,无明显副作用。

AIM：To observe the effect of anterior transposition of the inferior oblique muscle on dissociated vertical deviation （DVD） with inferior oblique muscle overaction. METHODS. A total of 8 cases 11 eyes diagnosed as DVD with inferior oblique muscle overaction were observed in this study. The inferior oblique muscle was transposed to 2mm anterior or in line with the temporal border of the inferior rectus insertion in all patients; the horizontal rectus muscle was operated on for horizontal strabismus in 5 cases. RESULTS. The inferior oblique muscle overaction was eliminated in all cases , 6 eyes with 1 ＋ and 2 of 3 eyes with 2 ＋ degree of DVD had no evidence of DVD, 1 of 3 eyes with 2 ＋ and 1 of 2 eyes with 3 ＋ degree of DVD had 1＋ degree of DVD, 1 of 2 eyes with3＋ degree of DVD had 2 ＋ degree of DVD. CONCLUSION. Anterior transposition of the inferior oblique is an effective method for DVD with inferior oblique muscle overaction and no side effect has been observed.