不同术式治疗垂直分离性斜视的临床疗效分析

目的探讨治疗垂直分离性斜视（DVD）的最佳手术方式。方法对43例（72眼）DVD根据不同的术前检查结果选择不同的术式。有下斜肌亢进者首选下斜肌切断加转位，根据亢进程度不同决定下斜肌在转位之前的截除量。无下斜肌亢进者首选上直肌后退术。双眼DVD不伴有下斜肌功能亢进者，且上斜程度相等者行双跟上直肌等量后徙术；双眼上斜程度不等者行双眼上直肌不等量后徙，或先行上斜明显眼手术，改期行另眼手术；合并水平斜视者尽可能同时完成，否则先矫正水平斜视，半年后矫正DVD。结果52眼疗效良好（72．22％），16眼好转（22．22％），4眼（5．56％）无效，1眼（1．38％）退上直肌和双眼外直肌后出现继发内斜视和对侧眼下斜肌亢进。结论对不同类型的DVD采用不同的术式可获得良好的疗效。

Clinical analysis of different surgery for dissociate vertical deviation

Objective To observe the efficiency of surgical correction of strabismus with adjustable suture in treating acute concomitant esotropia. Methods 12 acute concomitant esotropia cases were treated by surgical correction of strabismus with adjustable suture and synoptophore training for 15 days postoperatively. Results Postoperative diplopia: 11 cases regained binocular single vision without diplopia at the near or far distance. 1 case remained 8 prism diopters(PD) esotropia postoperatively, with no diplopia within 1 meter and diplopia alleviated significantly beyond 1 meter. Conclusion The effect of surgical correction of strabismus with adjustable suture in treating acute concomitant esotropia is satisfactory.