先天性双上转肌麻痹临床特点分析及手术治疗探讨

目的 探讨先天性双上转肌麻痹临床特点及手术疗效.方法 对12例患者进行斜视度、临床特点及双眼视功能检查,根据不同临床表现选择斜视手术方式,并观察术后短期、长期的斜视度和双眼视功能变化.结果 12例患者术前上直肌和下斜肌的运动均明显受限.12例中2例有双眼视功能,均无市体视觉.术后长期治愈率为75%.长期随访患者垂直斜视度较术前明显减小,差异具有统计学意义.4例患者有一定的双眼视功能恢复,手术前后差异无统计学意义.结论 先天性双上转肌麻痹应根据临床表现选择相应的手术方式.对于年龄小、尤其具有代偿头位患儿应积极进行手术治疗,以达到恢复或重建双眼视功能目的 .

Study on clinical features and surgical treatment of congenital ocular muscle patsy characterized with double elevator dysfunction

Objective To investigate the clinical features of congenital ocular elevator muscle palsy and to evaluate the efficacy of surgical treatment.Methods Eye position,clinical features and binocular visual function were examined in 12 patients pre- and post-operatively.Proper operative methods were selected according to clinical features.Results Before operation,the functions of superior rectus muscle and inferior oblique muscle in the 12 patients were restricted and no case had stereoacuity while two of them had binocular visual function.The long-term cure rate of strabismus was 75%.The hyperdeviation of cases decreased significandy compared with that before operation,which showed significant difference.The long term follow up survey showed that the recovery of binocular visual function only found in 4 cases,which showed no significant difference.Conclusions Different operative methods should be selected according to different clinical features.To recover or rebuild the patients' binocular visual function,operation should be taken actively on the younger patients who have compensatory head posture.