垂直眼外肌移位术治疗复杂斜视的研究进展

Research progress of vertical extraocular muscle transposition to treat complicated strabismus

垂直直肌移位术是治疗复杂类型斜视的常用手术方式,以往多采用上下直肌同时移位术治疗眼球运动障碍的水平斜视,然而上下直肌同时移位不能同期联合水平肌手术,否则可能影响眼前节血供,所以对于复杂斜视往往需要分期手术,二期手术再行水平肌的减弱术。近年来直肌移位术式发展迅速,出现了单独上直肌移位、单独下直肌移位和Nishida直肌移位等方式,因为避免同时切断两条垂直肌,或者避免切断垂直直肌,所以可以同期联合水平肌手术,增加一次手术的矫正率,同时避免眼前节缺血的风险。本文综述了垂直直肌移位术治疗外转受限内斜视、内转受限外斜视以及旋转斜视等复杂类型斜视的研究进展。

Vertical rectus transposition is a common operative method to treat complicated strabismus. Full tendon superior and inferior rectus transposition was the most popular procedure to treat horizontal strabismus with motility disorder. However, both superior and inferior rectus transposition could not combine with horizontal rectus surgery in case of anterior segment ischemia, so two stages surgery was often needed and horizontal rectus recession was reduction at second stage. Recently, vertical rectus transposition developed fast with the appearance of superior rectus transposition, inferior rectus transposition, and Nishida rectus transposition, which could combine with horizontal rectus recession at same stage, to increase the correction rate of one-off operation and avoid the possibility of anterior segment ischemia, because they avoided cutting off two vertical rectus at the same time or anyone vertical rectus. This paper reviewed the research progress of vertical rectus transposition in treatment of complex type strabismus which including abduction disability esotropia, adduction disability exotropia, cyclotropia.