直肌移位联合改良肌联结术治疗麻痹性内斜视

目的：观察直肌移位联合改良的肌联结术治疗麻痹性内斜视的手术效果。方法对31例（33眼）麻痹性内斜视病人采用直肌移位联合改良加强的肌联结并同时行相应内直肌后徙术治疗。观察术后原在位眼位、代偿头位、眼球运动及复视的改善效果。随访6月~36月，平均14.5月。结果术后26例（27眼）原在位〈＋10△，2例（3眼）欠矫10△以上，3例（3眼）轻度过矫。原在位满意者（＋10△~-10△）占90.9%。术后27例代偿头位矫正。2例残存微小头位。外转过中线5°~20°，平均9°。随访期间过矫的3例恢复。原在位满意者占81.8%。未发现眼前节缺血并发症。结论直肌移位联合改良的肌联结术是一种有效治疗麻痹性内斜视的良好方法。

The rectus shift joint improved muscle connection surgery on paralytic esotropia

To observe operative effects of paralytic esotmpia by rectus shift joint improved muscle connection. Methods 33 eyes of 31 patients with paralytic esotropia were undergone rectus transposition jointed im-provement strengthen muscle coupling and at the same time conbined with medial rectus recession. Primary eye posi-tion, compensatory head position and improvement effect of diplopia were followed up 6 months to 36 months after Surgery. Results 27 eyes of 26 cases of postoperative primary position were〈 ＋10？, 3 eyes of 2 cases were more than＋10？, 3 eyes of 3 cases had slightly overcorrection, The operation result were satisfactory for 90.9% of all patients. Compensatory head posture of 27 postoperative patients were satisfied. 2 cases remaining small compensatory head po-sition. The ocular abduction could across the midline from 5oto 20o（9oin average）. In the follow-up period, 3 cases of the overcorrection patients were recovered , 81.8% of patients had got satisfied primary positions.The anterior segment ischemia did not happen. Conclusions The rectus shift joint improved muscle connection might be an effective method to paralytic esotmpia.