下斜肌后固定术治疗轻度垂直斜视的效果

Posterior fixation of inferior oblique muscle in the treatment of mild vertical strabismus

目的探讨下斜肌后固定术治疗伴有下斜肌功能亢进的轻度非共同性垂直斜视的效果。方法回顾性分析徐州市第一人民医院2017年12月至2020年3月轻度垂直斜视17例的临床资料,患者均伴有单眼下斜肌+1级〜+3级功能亢进。所有患者均接受下斜肌后固定术治疗。术后随访3〜6个月,分析手术后垂直斜视度、下斜肌功能及黄斑视盘夹角(FDA)的变化。结果手术后垂直斜视度由手术前(5.76±1.71)PD改善为(0.12±0,49)PD,差异有统计学意义(t=14.391,P<0.001);下斜肌功能分级由(1.82±0.64)级减少为0级,差异有统计学意义(t=11.823,P<0.001);手术后FDA变化差异无统计学意义(t=1.339,P=0.199)。随访期间下斜肌亢进、垂直斜视度、代偿头位均改善,无过矫。结论下斜肌后固定术治疗伴有下斜肌功能亢进的轻度垂直斜视安全而有效。

Objective To investigate the efficacy of posterior fixation of inferior oblique muscle in the treatment of mild incomitant vertical strabismus with inferior oblique muscle overaction.Methods The clinical data of 17 cases of mild vertical strabismus with monocular inferior oblique muscle overaction,grade+1 to+3,who underwent posterior fixation of inferior oblique muscle from Dec.2017 to Mar.2020 in Xuzhou No.1 People*s Hospital were retrospectively analyzed.With 3-6 months follow-up,the changes of vertical deviation,function of inferior oblique muscle and fovea disc angle(FDA)were measured and analyzed.Results After operation,the vertical deviation was improved from(5.76±1.71)PD to(0.12±0.49)PD(t=14.391,P<0.001),and the grade of the inferior oblique overation was changed from(1.82±0.64)level to 0 level(t=11.823,P<0.001).There was no significant difference in FDA changes before and after surgery(t=1.339,P=0.199).After operation,the inferior oblique muscle overaction,the vertical deviation and the compensatory head position were all improved,without overcorrection.Conclusion The posterior fixation of inferior oblique muscle is a safe and effective method for the treatment of mild vertical strabismus with inferior oblique muscle overaction.