先天性上斜肌麻痹手术治疗的临床疗效观察

目的探讨先天性上斜肌麻痹的手术治疗效果.方法将我院近两年来先天性上斜肌麻痹患者35例,采用下斜肌断腱术、下斜肌部分切除术或联合上斜肌折叠术,对侧下直肌后退术或同侧上直肌后退术治疗;如合并内、外斜视可联合内外直肌手术.结果垂直斜视完全矫正29例(82.85%),术后残留上斜度数1.7△～3.4△5例(14.28%),无效1例.术后随访1年,代偿头位完全消失16例(80%),代偿头位改善4例(20%).结论先天性上斜肌麻痹的手术治疗效果良好,应尽早进行手术治疗,对于矫正代偿头位有利.     

先天性上斜肌麻痹的手术方式选择

目的 对先天性上斜肌麻痹的手术方式选择进行探讨。方法 回顾性总结我科１９８９年８月￣１９９８年８月间收治的３４例单眼上斜肌麻痹和双眼上斜肌麻痹患者的手术效果,并对手术失败者进行原因分析。结果 ３４例上斜肌麻痹患者原在位生趣斜视矫正２７例,伴水平斜视及Ｖ型斜视者均获得矫正。结论 上斜肌麻痹的手术方式首选减拮抗肌下斜肌或同时弱拮抗肌下斜肌和配偶肌下直肌,儿童下斜肌减弱术应首选下斜肌后行徒术。     

不同术式治疗先天性上斜肌麻痹的疗效观察

目的 探讨不同术式治疗先天性上斜肌麻痹的疗效及适应症.方法 本研究回顾分析30例先天性上斜肌麻痹患者手术方式和术后效果.根据下斜肌亢进程度和垂直斜视度数及患眼外旋程度选择不同的手术方式:下斜肌部分切除术、下斜肌前转位术,或联合上直肌或下直肌手术.结果 治愈25例,治愈率83.3%;好转5例,好转率16.7%.结论 根据...     

不同术式治疗先天性上斜肌麻痹疗效分析

目的 探讨先天性上斜肌麻痹的不同手术方式的治疗效果.方法 根据原在位垂直斜视度和眼外肌的功能状况,对47例先天性上斜肌麻痹患者实施不同的手术方式进行分析.结果 术后随访3～24个月,其中40例(85.1%)眼位为正位,7例(14.9%)眼位较前好转.30例(63.8%)代偿头位消失,8例(17.0%)代偿头位减轻.治愈30例(63.8%),好转17例(36.2%),总有效率100%.结论 先天性上斜肌麻痹手术方式的选择按照减弱直接拮抗肌及配偶肌,加强麻痹肌原则进行.根据下斜肌亢进程度和垂直斜视度数选择不同手术方式可达到良好治疗效果.     

上斜肌麻痹的手术疗效分析

目的比较上斜肌麻痹的不同术式的疗效.方法对316例上斜肌麻痹患者的不同手术方式进行分析.结果几种不同手术方式治愈率分别为90.48%,80.65%,47.37%,33.3%,84%和81.7%.结论斜视≤10.的患者,行单纯下斜肌部分切除术效果最好;斜视＞10°的患者,行下斜肌部分切除加对侧眼下直肌徙后术效果较好;上斜肌麻痹伴有内、外斜患者1次行下斜肌部分切除加内、外斜矫正效果亦较好.     

先天性上斜肌麻痹的手术疗效分析

目的探讨先天性上斜肌麻痹的临床表现、常用检查方法及手术选择的基本原则。方法对40例上斜麻痹患者的不同手术方式进行分析结果40例患者术后随访一年,治愈34例,好转4例,无效2例。结论先天性上斜肌麻痹是垂直眼外肌麻痹中最常见的一种,手术术式选择首选减弱直接拮抗肌和配偶肌,伴内、外斜视者行下斜肌手术同时行内外斜视矫正。     

先天性上斜肌麻痹的手术治疗

目的探讨先天性上斜肌麻痹的各种手术方法与疗效及适应症。方法回顾性分析112例先天性上斜肌麻痹患者分别行患眼下斜肌断腱、下斜肌部分切除、下斜肌后徙转位、下斜肌后徙转位联合健眼下直肌后徙术的术后效果。结果术后平均随访22月（7～36月）,下斜肌断腱术22例,术后满意率86.36%,下斜肌部分切除术16例,术后满意率87.5%,两者治疗效果相当,无明显统计学差异;下斜肌后徙转位54例,术后满意率88.89%;下斜肌后徙转位联合健眼下直肌后徙术20例,术后满意率80%。结论先天性上斜肌麻痹患者应根据术前垂直斜视度的大小选用不同的手术治疗方法,且应该早期治疗。下斜肌断腱和下斜肌部分切除术治疗效果相当,适用于矫正垂直斜视度〈15~△者;下斜肌后徙转位适用于矫正垂直斜视度15~△～25~△者;下斜肌后徙转位联合健眼下直肌后徙术适用于矫正垂直斜视度〉25~△者。     

先天性上斜肌麻痹的手术方式分析

目的:探讨先天性上斜肌麻痹的手术治疗方法。方法:对我院2004-10/2005-02收治的39例先天性上斜肌麻痹患者,根据患眼的下斜肌功能亢进程度和垂直斜度大小选择下斜肌后徙、下斜肌切断并部分切除、下斜肌前转位、或联合对侧眼上直肌、下直肌手术。结果:治愈28例(72%),好转10例(26%),无效1例(2%)。结论:先天性上斜肌麻痹的手术方式按减弱直接拮抗肌和配偶肌,加强麻痹肌和间接拮抗肌的原则进行,根据患者下斜肌功能亢进程度和垂直斜视度大小选择不同术式可获得良好的效果。     

先天性上斜肌麻痹手术治疗分析

先天性上斜肌麻痹是先天性垂直斜视中最为常见的一种,本病多发生于幼儿期,单眼发病较为多见,其临床特征常常表现为上斜视继发下斜肌功能亢进及斜颈。目前对该病的治疗主要是手术矫正.包括下斜肌断腱术、截除术及下斜肌后徙术、下斜肌前转位术等。本文对48例先天性上斜肌麻痹采用下斜肌后徙转位手术治疗,取得了良好的效     

先天性上斜肌麻痹手术治疗的年龄探讨

目的:探讨先天性上斜肌麻痹的早期手术治疗年龄。方法:回顾性总结我科7mo～7岁21例先天性上斜肌麻痹患者接受下斜肌部分切除术的手术效果。结果:本组7mo～7岁21例患儿垂直斜视及伴水平斜视和V型斜视术后均获矫正,20例代偿头位完全改善,1例部分改善,术后1wk内头位完全矫正率2岁以下为91%(10/11),2岁以上40%(4/10)。21例Bielschowsky歪头试验全部阴性,无1例并发症发生。结论:先天性上斜肌麻痹一经确诊,应及时手术。1岁内患儿有代偿头位,垂直斜视,且Bielschowsky歪头试验阳性,全身状况良好者,可即行手术矫正。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.