后天性外旋转斜视的临床及手术治疗

The clinical characteristics and the surgical treatment of acquired excyclotorsion

目的 :探讨后天性外旋转斜视的临床特点及治疗方法。方法 :回顾分析 2 1例后天性外旋转斜视病例。结果 :本组病例的临床特点为 :1有明确的外伤病史 ;2患者有极明显的下半视野复视 ;3双马德氏三棱镜检查阳性 ;4双马德氏杆检查为外旋转斜视。本组病例中有 4例经保守治疗后仍有眼位偏斜而行手术治疗 ,手术方法采用 Harada- Ito术式或改良的Harada- Ito术式 ,4例手术病人术后均外旋斜消失 ,有立体视觉存在。结论 :当外伤或其他病史所致患者有明显的下半视野复视时 ,要注意外旋斜视的诊断 ,外旋斜视保守治疗无效时应手术治疗。

Objective: To study the clinical peculiarity and treatment of acquired excyclotorsion. Method: A retrospective review of 21 cases of excyclotorsion had been done. Results: Clinical characteristics were as follows: 1) had definite traumatic history, 2) had obvious diplopia in downgaze field, 3) double Maddox prism test was positive, 4) excyclotorsion shown on double Maddox rod test. In 4 cases, excyclotorsion were disappeared under Harada-ito or modified Harada-ito procedures, and Ⅲo stereoscopic vision were regained postoperatively. Conclusions: Excyclotorsion should be considered in those ocular traumatic patients who with obvious downgaze diplopia. Surgical treatment could be run if failure of traditional treatment.