摘要
目的 探讨外斜视A征的临床特征和有效的手术治疗方法。方法 对 32例外斜视A征患者行上斜肌减弱术、内直肌缩短术或 (和 )外直肌后退术 ,观察手术前、后患者眼位、斜视度数和临床特征的改变。结果 在 32例外斜视A征患者中 ,上斜肌功能亢进 31例 (双眼 2 7例 ,单眼 4例 ) ,内直肌功能不足 2 0例 (双眼 16例 ,单眼 4例 )。行上斜肌部分肌腱切除术 13例 (双眼 12例 ,单眼1例 ) ,行上斜肌肌腱切断术 18例 (双眼 15例 ,单眼 3例 ) ;行内直肌缩短术 17例 (双眼 11例 ,单眼6例 ) ,行单眼内直肌缩短及外直肌后退术 10例 ;行外直肌后退术 4例 (双眼 1例 ,单眼 3例 )。术后眼位恢复至正位 2 8例 ( 87 5 %) ,外斜视A征消失 31例 ( 96 9%) ,其中 4例患者术后获得双眼单视功能。结论 外斜视A征作为斜视A V综合征中的主要斜视类型 ,上斜肌功能亢进和内直肌功能不足是其发病的主要原因和临床特征 ;矫正外斜视A征的有效手术治疗方法是上斜肌减弱术和外斜视矫正术。
Objective To investigate the clinical features of A-pattern exotropia and to evaluate the efficacy of surgical treatment for the correction of A-pattern exotropia (A-XT). Methods Pre- and post-operative eye position, superior oblique muscle function, clinical features and binocular function were examined and analyzed in 32 patients with A-pattern exotropia. Results Overaction of the superior oblique (SO) (31/32) and insufficiency of medial rectus muscle (20/32) were commonly seen in the group of patients. The tenectomy of the SO and the resection of the medial rectus muscle were effective in most of A-pattern exotropia. 87.5% (28/35) of A-pattern exotropia in our study were successfully corrected. Four cases got binocular function after surgery. Conclusions Based on the clinical features and the effects of surgical treatment, we conclude that the superior oblique muscle overaction and medial rectus muscle insufficiency are the primary factors in the etiology of A-pattern exotropia that is the most common form of A-V syndrome. Weakening the overaction of superior oblique muscle combined with the correction of exotropia is an effective way to correct A-pattern exotropia.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2003年第3期156-159,共4页
Chinese Journal of Ophthalmology
