动眼神经不全麻痹所致外上斜视的手术治疗

Strabismus surgery for exohypertropia caused by ocular nerve paresis

目的探讨动眼神经不全麻痹所致外上斜视的手术治疗方法及疗效。方法取收治的5例的动眼神经不全麻痹所致外上斜视患者进行回顾性分析，手术方式均采用外直肌移位至下直肌附着点联合内直肌大量缩短，随访观察半年。结果5例患者眼位均明显改善，第一眼位映光基本正位，内转及下转较前明显改善，外转有轻中度受限。患者均无复视，手术效果满意。结论外直肌移位联合内直肌大量缩短可有效矫正动眼神经不全麻痹所致外上斜视，手术肌肉条数少，无须分次手术，疗效满意。

Objective To evaluate the surgical method and effect of exohypertropia caused by ocular nerve paresis. Methods The clinical characters and surgical outcome of 5 exohypertropia patients caused by ocular nerve paresis were analyzed retrospectively. All patients accepted strabismus surgery by transposing lateral rectus to inferior rectus insertion combined with large medial rectus resection. The mean time of follow up was 6 months. Results All patients obtained orthophoria on the primary position. Adduction and subduction of the paretic eye were improved significantly, while abduction of the eye was limited slightly. No diplopia was found. Conclusions Lateral rectus transposition combined with medial rectus resection is effective in treating exohypertropia caused by ocular nerve paresis.