斜视转位手术之改良Nishida术式应用的研究进展

Advance on the application and progress of modified Nishida procedure for transposition of strabismus

麻痹性斜视常应用垂直肌转位术(VRT)矫正。术式包括Hummelsheim术式、Jensens术式、Foster术式及Nishida术式等,各种术式各有利弊。其中,改良后的Nishida术式因不切开肌肉而极大地减少了术后眼前节缺血的风险,对不同疾病导致的眼球运动障碍疗效显著。本文中笔者就该术式在眼球上转不足(先天性双上转肌麻痹)、眼球外转不足(外展神经麻痹和Duane综合征Ⅰ型)、眼球内转不足(先天性内直肌缺如和内窥镜鼻窦手术后的内直肌横断)、眼球下转不足(各种原因导致的下直肌麻痹和先天性下直肌发育不全)等治疗应用中的研究进展进行综述,旨在为临床中麻痹性斜视的治疗提供参考。

Vertical rectus muscle transposition(VRT) is usually used to correct patients with paralytic strabismus. There are many surgical methods, including Hummelsheim, Jensens, Foster, and Nishida. Each has its advantages and disadvantages. Among them, the modified Nishida procedure is of great benefit to reduce the risk of postoperative anterior segment ischemia because of non-cuting the muscles. Therefore, it is widely used in the treatment of eye movement disorders caused by various diseases. The insufficient upward rotation of the eye(congenital double superior transposition palsy), insufficient extraocular rotation(abducens nerve palsy, Duane syndrome type Ⅰ), insufficient intraocular rotation(congenital rectus absence, rectus transection after endoscopic sinus surgery), insufficient eyeball downturns(inferior rectus palsy caused by various reasons, and congenital inferior rectus dysplasia) were reviewed in this paper.