不同术式矫正A-V综合征临床分析

目的:分析A-V型斜视发病率、病因,探讨A-V型斜视不同术式的治疗效果。方法:按第一眼位斜视度数设计水平方向的手术量,对合并轻度上?下斜肌功能亢进(A-V征15Δ～20Δ)及仅有水平肌功能异常者行水平直肌垂直移位术;上?下斜肌功能亢进明显者(+2～+3),行上?下斜肌减弱术。结果:62例A-V综合征中合并上?下斜肌功能异常者35例,仅有水平肌功能异常者27例。行上、下斜肌减弱术21例,行水平直肌垂直移位术41例,两种手术效果无显著差异。结论:产生A-V综合征的因素较多,多数A-V型斜视都有斜肌功能异常,对上?下斜肌功能亢进明显者,行上?下斜肌减弱术,对合并上?下斜肌功能亢进较轻及仅有水平肌功能异常者行水平直肌垂直移位术,手术效果良好,两种术式效果无显著差异。

Clinical analysis on different surgical approaches for A-V syndrome

AIM:To analyze the incidence and etiology of A-V strabismus,and to explore the therapeutic effect of A-V patterns strabismus with different surgical approaches.·METHODS:Horizontal amounts of muscle surgery were designed based on degree of deviation in primary position.For A-V pattern strabismus with minor over-action of superior or inferior oblique muscles (A-V 15Δ-20Δ) and horizontal retus disfunction merely,vertical transposition of horizontal retus insertions was performed.For obvious over-action of superior or inferior muscles (+2-+3),superior or inferior oblique weakening procedure was performed.·RESULTS:Sixty-two cases of A-V syndrome were studied.Among them,there were 35 cases with superior or inferior oblique disfunction,27 cases with only horizontal retus disfunction.Superior or inferior oblique weakening procedure was performed in 21 cases.Vertical transposition of horizontal retus insertions was performed in 41 cases.No significant difference was observed between two surgical effects.·CONCLUSION:Many factors are involved in A-V syndrome.Most A-V pattern strabismus has oblique muscle disfunction.For obvious superior or inferior oblique over-action,oblique weakening procedure is performed;For minor superior or inferior oblique over-action and only horizontal retus disfunction,vertical transposition of horizontal retus is performed.Both surgical effects are good and no significant difference is observed.·