水平肌肉垂直移位治疗恒定性外斜视合并小角度垂直斜视效果观察

Clinical observation on treatment of constant exotropia with small angle vertical strabismus by vertical displacement of horizontal muscles

目的探讨小范围水平肌肉垂直移位治疗恒定性外斜视合并小角度垂直斜视的临床效果。方法回顾性分析术中矫正水平斜视的同时并对水平肌肉止端垂直移位矫正9例(14眼)恒定性外斜视伴小角度垂直斜视的临床治疗效果。结果患者水平外斜视和小角度垂直斜视都得到矫正,6例10眼患者垂直眼位消失,1例双眼患者术后由L/R7△变成L/R3△,2例单眼患者术后由R/L6△变成R/L2△。随访3个月～15个月(平均6个月)期间全部患者均未出现医源性眼球旋转现象,无代偿头位及医源性A-V现象,无复视。结论单纯水平肌肉小范围垂直移位可有效治疗恒定性外斜视合并小角度垂直斜视。

Objective To observe the therapeutic effect of small range horizontal muscle vertical displacement on constant exotropia combined with small angle vertical strabismus.Methods 14 eyes of 9 cases with constant exotropia and small angle vertical strabismus were corrected by correction of horizontal strabismus and vertical displacement.Results both horizontal exotropia and small angle vertical strabismus were corrected in 6 cases (10 eyes),1 case of binocular surgery from L/R7 to L/R 3 and 2 cases of monocular surgery from R/L 6 to R/L 2. No iatrogenic eye rotation, no compensatory head position and iatrogenic A-V, no diplopia occurred in all patients during the 3-15 months follow-up (mean 6 months).Conclusion The treatment of constant exotropia with small angle vertical strabismus is simple horizontal muscle small range vertical displacement.