Duane眼球后退综合征21例手术治疗临床观察 |
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引用本文: | 周畅达,张小红,秦剑英,陈忠飞,程福荣. Duane眼球后退综合征21例手术治疗临床观察[J]. 眼外伤职业眼病杂志, 2011, 33(9): 660-663 |
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作者姓名: | 周畅达 张小红 秦剑英 陈忠飞 程福荣 |
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作者单位: | 1. 061001,河北沧州眼科医院 2. 承德市,承德区学管院影像教学实验室 |
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摘 要: | 目的探讨眼球后退综合征(DRS)的临床特点和手术方法。方法21例眼球后退综合征根据术前不同的斜视度、斜视类型、牵拉实验结果、同视机检查结果以及眼球内转时是否伴有上射和(或)下射现象,在解除限制因素的前提下分别采取内直肌后退或悬吊术,外直肌后退或悬吊术,内外直肌同时后退或悬吊术以及外直肌Y型劈开联合后退术。结果术后内转眼上射和(或)下射现象及代偿头位有不同程度的改善或消失。14例内斜视术后12例斜视度≤10^△,2例斜视度〉10△.其中2例在行内直肌后退术后出现外斜视。7例外斜视中,5例行外直肌后退或悬吊术,2例行外直肌Y型劈开联合后退术,其中6例术后斜视度≤10△,1例斜视度〉10△。结论在解除限制因素的前提下,水平直肌大量后退可以消除或改善代偿头位,亦可恢复原在位的眼位。对于斜视度≤20△且有代偿头位的DRS患者,可以戴棱镜矫正。直肌Y型分开联合后退术或水平直肌同时后退术在解决内转眼上射和(或)下射现象时有显著疗效。
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关 键 词: | Duane眼球后退综合征 手术 眼外肌 |
Clinical analysis of surgical treatment for 21 cases with Duane's retraction syndrome |
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Affiliation: | ZHOU Chang- da, ZHANG Xiao-hong, QIN Jian-ying, et al. Cangzhou Eye Hospital, Cangzhou, Hebei 061001, China |
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Abstract: | Objective To investigate the characters of Duane's retraction syndrome (DRS) and the individualized surgical plan.Methods According to the character of DRS,we treated it with four methods:the medial rectus recession combined with ventrofixation,external rectus recession combined with ventrofixation,medial rectus and external rectus muscle simultaneously combined ventrofixation or external rectus muscle Y-shaped division.Results Upshoot and/or downshoot phenomenon and the head compensation position improved or cured postoperatively.Deviation angle of 12 patients was≤ 10△ in 14 patients with esotropia.Two cases appeared exotropia after medical rectus recession.Deviation angle of 6 cases of 7 patients with exotropia was ≤ 10△.In which five cases were performed external rectus muscle recession combined with ventrofixation; 2 cases were performed external rectus muscle Y shaped division.Conclusion Excluding the limiting factor,adequate recession of horizontal rectus could improve or remove the compensation head position.To help the patient with the head compensation position and strabismus ≤20△,we could give prismatic glasses.The curative effect is notable when the rectus Y shaped division with recession or both horizontal rectus recession simultaneously was done for upshoot or downshoot phenomenon. |
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Keywords: | Duane's retraction syndrome Operation Extraocular muscles |
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