下直肌后徙术在先天性单眼上斜肌麻痹的应用

目的探讨下直肌后徙术在先天性单眼上斜肌麻痹性斜视治疗中的效果及适应症。方法回顾性分析32例行下直肌后徙术治疗的先天性单眼上斜肌麻痹性斜视患者,观察术后垂直斜视度、双眼单视功能及代偿头位的变化。结果32例患者术前第一眼位垂直斜视度10^△～25^△（平均为14.13^△）;术后0～8^△（平均为3.8^△）,较术前有显著减少（Z=-2.11,P〈0.01）。32例患者术前4例（12.5%）具有融合功能,2例（6.25%）有立体视功能,术后继续保持,另有22例（68.75%）融合建立,6例（18.75%）立体视建立,较术前均有显著性差异（χ^2=2.419,P〈0.05）。结论下直肌后徙术是治疗先天性上斜肌麻痹性斜视的有效术式,术前详细检查,掌握适应症,合理设计手术方案,可取得良好手术效果。

The application of inferior rectus recession in congenital unilateral superior oblique paralytic strabismus

Objective To investigate the effect and principles of inferior rectus recession in congenital unilateral superior oblique paralytic strabismus . Methods It was a retrospective study. The changes of vertical strabismus angle and compensatory head posture after inferior rectus recession were observed for 32 cases of congenital unilateral superior oblique paralytic strabismus. Results In 32 cases, the vertical strabismus angle of the first eye position was 10^△～25^△ preoperatively（14.13^△ in average）and 0～8^△ postoperatively（3.8^△ in average）,reducing significantly after operation（Z=- 2.11,P0.01）. 4 cases of them（12.5%）who with fusion and 2（6.25%）who with stereopsis reserved their function after operation. Another 22 cases（68.75%）reestablished fusion function and 6（18.75%）reestablished stereopsis, of which the differences had statistical significance （χ^2=2.419,P0.05）. Conclusions Inferior rectus recession is effectively to congenital superior oblique paralytic strabismus, and we can obtain a good effect by careful preoperative examinations, indications and a reasonable scheme.