共同性内斜视术后继发性外斜视与斜肌功能异常的关系

A correlation analysis of consecutive exotropia after correction of concomitant esotropia in patients with oblique muscle dysfunction

目的探讨共同性内斜视术后继发性外斜视与斜肌功能异常的关系。方法回顾性病例研究。2008年至2013年在四川大学华西医院眼科接受手术治疗的26例共同性内斜视术后继发性外斜视患者纳入研究，分析斜肌功能异常在发病因素中的作用。结果26例中14例发生了新发的斜肌功能异常，包括上斜肌功能亢进8例次、下斜肌功能不足2例次、下斜肌功能亢进6例次、上斜肌功能不足3例次。继发性外斜合并A—V征的8例，其中合并A征5例，V征3例。结论共同性内斜视术后发生的继发性外斜视可能与未矫正或新出现的斜肌功能异常相关。

Objective To investigate the pathogenesis and clinical significance of consecutive exotropia and the correlation with oblique muscle dysfunction. Methods A retrospective chart review was performed on 26 patients who underwent surgery for consecutive exotropia to study the correlation between consecutive exotropia and oblique muscle dysfunction. Results In this study, oblique muscle dysfunction was found in 14 patients among the 26 cases of consecutive exotropia, including 8 cases of inferior oblique muscle overaction and 6 cases of superior oblique muscle overaction, and 2 case of inferior oblique muscle underaction. Consecutive exotropia was accompanied with other ocular deviations in 8 patients. A-pattern exotropia was accompanied in 5 patients and it was more common than the V-pattern that developed in 3 patients. Conclusion Consecutive exotropia may be correlated with oblique muscle dysfunction.