肌腹下眶-球硅管连接术治疗固定性斜视

目的探讨在麻痹肌肌腹下行眶-球硅管连接术治疗固定性斜视的疗效。方法收集23例（23只眼）固定性斜视患者,其中内斜视22例,外斜视1例;11例为全固定性斜视,12例为亚固定性斜视（9例斜视眼可转动,但无法达到正视位,3例斜视眼转动可达到正视位）。行拮抗肌后退术后,用直径为1mm的硅管经麻痹肌腹下连接眦部眶骨膜和麻痹肌止端前巩膜。术后随访12～36个月,观察眼位和眼球运动情况。结果23例患者术后眼位均恢复至正视位。术眼可向麻痹肌侧转动达25％、50％及75％正常幅度者分别为5例、2例及3例。结论肌腹下眶-球硅管连接术借用硅胶的弹性,起到被动牵拉作用以矫正斜视,是治疗固定性斜视的可行方法,同时该手术具有硅胶不外露的优点。（中华眼科杂志,2005,41：817-820）

Silicone union of orbital periosteum and eyeball under muscle belly for treatment of strabismus fixus

Objective To evaluate the effect of silicone union of orbital periosteum and eyeball under muscle belly on the treatment of fixed paralytic strabismus.Methods The data from 23 cases (23 eyes) which included esotropia (22 eyes) and exotropia (1 eye) was collected, 11 and 12 patients were diagnosed as complete-fixed strabismus (CFS) and sub-fixed strabismus (SFS) respectively. After antagonist recession was completed, a silicone union (1 mm of its diameter) was used to make a connection between the anterior sclera of paralytic muscle insertion and lateral or medial canthus periosteum of orbital. Eyeball position was adjusted to orthophoria by the traction of silicone union.Results Orthophoria was obtained in all of 23 eyes.Eyes rotation compared with normal eye toward paralytic side were 25% (5 eyes),50%(2 eyes),75% (3 eyes) respectively after surgery. Conclusion Silicone union is a elastic material, it is one of better methods for the correction of fixed strabismus.