Effects of Ocular Parameters on Medial Rectus Faden Operation with Recession for Esotropia

Background: In the treatment of infantile and accommodative esotopia medial rectus (MR) recession combined posterior fixation suture (Faden operation) can be used. But, there is very limited literature on effect of ocular parameters (axial length, medial rectus width and the distance of medial rectus insertion to limbus) to this operation. Objective: To evaluate effects of ocular parameters on medial rectus Faden operations with recession for esotropia. Material and Methods: In this retrospective study, 38 patients (57 eyes) who underwent Faden operation with unilateral or bilateral recession (4 - 4.5 mm) on medial rectus were divided into three groups according to axial length, medial rectus width and the distance of medial rectus insertion to limbus. Preoperative and postoperative deviations compared. Results: 11 cases were infantile esotropia, 46 cases were acquired esotropia. Female/male rate was 19/19. The mean preoperative amount of esotropia at near was 49.95 ± 17.36 prism diopters (PD) and postoperative 1 week 11.77 ± 11.14 PD, 1 month 12.02 ± 11.52 PD and 6 months 9.46 ± 10.19 PD. The mean preoperative amount of esotropia at distance was 38.84 ± 19.03 PD and postoperative 1 week 7.25 ± 11.29 PD, 1 month 6.54 ± 10.52 PD and 6 months 4.40 ± 9.08 PD. Due to axial length, in shorter eyes, the decrease in mean post-operative deviation was statistically significant. Due to medial rectus width and the distance of medial rectus insertion, there was no statistically significant difference. Conclusions: Axial length has an effect on medial rectus Faden operations with recession but medial rectus width and medial rectus insertion distance from limbus do not.

Faden术在矫正非屈光调节性内斜视中作用分析

目的探讨Faden术在非屈光调节性内斜视矫正中的作用。方法取12例非屈光调节性内斜视，AC／A值〉7，远近斜视角相差在15n以上，根据斜视度行双内直肌Faden术或双内直肌后退联合Faden术。结果术后10例患者视远和视近时基本正位，1例视近仍残余〈＋15。内斜视，1例视远过矫。结论Faden术可有效矫正非屈光调节性内斜视的斜度。

单纯与双内直肌后徙联合Faden术矫正集合过强型内斜视的比较分析

目的比较单纯双内直肌后徙与双内直肌后徙联合Faden术在矫正集合过强型内斜视中的作用。方法28例集合过强型内斜视，远近斜视角相差在15。以上，AC／A值（6，看近斜视角为45～80^，看远25～45^△，一组12例行单纯双内直肌后徙，另一组16例行双内直肌后徙联合Faden术。结果12例行单纯双内直肌后徙组中9例视近仍残余〉10。内斜视。16例行双内直肌后徙联合Faden术组14例视近时基本正位，2例视近仍残余〉10^△内斜视，2例视远过矫。结论双内直肌后徙联合Faden术较单纯双内直肌后徙可有效矫正集合过强型内斜视，但需要注意防止过矫。

后天性外展神经全麻痹的手术治疗

目的回顾性分析内直肌Faden后固定术联合外直肌Jensen肌肉连接术治疗后天性外展神经全麻痹的疗效。方法 26例后天性外展神经全麻痹的患者在我科行内直肌Faden后固定术联合外直肌Jensen肌肉连接术,应用同视机、三棱镜、线状镜等观察手术前后斜视度、眼球运动、代偿头位及双眼视觉的改变。结果术后1年,26例患者中有24例斜视度在+15△以下,手术成功率为92.31%,与术前相比所有患者眼球运动明显改善,除2例患者术后并发内直肌挛缩需要二次手术外,其余患者代偿头位消失,并恢复了双眼单视功能。结论内直肌Faden后固定术联合外直肌Jensen肌肉连接术是治疗后天性外展神经全麻痹的有效方法。