上直肌转位联合内直肌后徙术治疗外展神经麻痹性内斜视的临床疗效

目的 探讨上直肌转位(SRT)联合内直肌后徙术(MRC)治疗外展神经麻痹性内斜视的临床疗效.方法 回顾性系列病例研究.收集2017年9月至2020年3月郑州大学第一附属医院斜视与小儿眼科专业组收治的应用SRT联合MRC治疗的38例(50眼)外展神经麻痹性内斜视患者的临床资料.采用三棱镜角膜映光法测量所有患者第一眼位斜视...

Clinical efficacy of superior rectus transposition combined with medial rectus recession in the treatment of sixth nerve paralytic esotropia

Objective　To investigate the clinical efficacy of superior rectus transposition (SRT) combined with medial rectus recession (MRC) in the treatment of sixth nerve paralytic esotropia.Methods　It was a retrospective study involving 38 patients (50 eyes) with sixth nerve paralytic esotropia who were admitted in the Department of Strabismus and Pediatric Ophthalmology, the First Affiliated Hospital of Zhengzhou University from September 2017 to March 2020. The strabismus and the limitation of eyeball abduction at the primary position of eye were detected using the prism keratometry, and the Hirschberg test, respectively. Near and far stereoscopic visions were respectively assessed by near stereoscopic images and random-dot stereogram synoptophone. Patients were followed up for 6-14 months. The strabismus and the limitation of eyeball abduction at the primary position of eye before and after surgery were compared by the paired sample t test, and stereoscopic visions before and after surgery were compared by Chi-square test. Results　The angle of deviation in the primary eye position in 38 patients with sixth nerve paralytic esotropia decreased from (75.53±13.17) PD preoperatively to (5.93±2.46) PD postoperatively (t=12.49, P=0.00). Besides, the limitation of eyeball abduction improved from -4.50±0.68 preoperatively to -1.87±0.55 postoperatively (t=-13.00, P=0.00). Near stereopsis was recovered postoperatively in 20 cases and far stereopsis was recovered in 17 cases. Two patients suffered residual small-angle horizontal strabismus, while the diplopia was eliminated after wearing press-on prism. New vertical and rotational strabismus was not observed in all cases.Conclusion　SRT combined with MRC can effectively correct the sixth nerve paralytic esotropia, and reduce the number of involved extraocular muscles without obvious vertical and rotational strabismus.