眼球后退综合征的手术治疗进展

Progress in surgical treatment on duane retraction syndrome

眼球后退综合征是一种先天性的眼球运动异常和特殊类型的斜视。发病机制为先天性的展神经核和(或)展神经未发育或发育不良,和动眼神经分支对外直肌的异常支配。由于不同程度的神经支配异常,表现为不同方向和程度的眼球运动受限,常伴有眼球内和(或)外转出现眼球后退,常伴有睑裂变化和上、下射现象。根据神经异常支配程度不同,患者临床特征变化多样,根据不同的临床特征,一般分为3型。本文分别对各型眼球后退综合征的水平和垂直斜视,眼球后退和上、下射现象的手术治疗方法进展进行了综述,强调应当根据每个患者不同的斜度,代偿头位,眼球后退和上、下射情况进行个体化的手术设计。

Duane retraction syndrome(DRS)is a congenital eye movement anomaly characterized and specific strabismus.The pathogenesis is congenital abducens nerve nucleus and/or abducent nerve undeveloped or dysplasia,and abnormal innervation of oculomotor nerve branches to external rectus muscle.Because of different degrees of abnormal innervation,it is manifested as restriction of eyeball movement in different directions and degrees,often accompanied by eyeball retraction while intraocular and/or extraocular rotation,often accompanied by palpebral fissure changes and upshoot or downshoot.According to the degree of abnormal innervation,the clinical characteristics of patients are varied.According to different clinical features,they are generally divided into three types.This article reviews the advances in surgical treatment of horizontal and vertical strabismus,eyeball retraction and upshoot or downshoot in various types of DRS,emphasizing that individual surgical design should be made according to the different slope of each patient,compensatory head position,eyeball retraction and upshoot or downshoot.