摘要
目的:探讨Duane眼球后退综合征(DRS)手术治疗的方法和效果。方法:对13例因DRS行手术治疗患者的临床表现、手术治疗方式和效果进行回顾性总结和分析。结果:单眼受累12例,双眼受累1例。Ⅰ型内斜视9例(双眼1例);Ⅱ型外斜视3例;Ⅲ型1例。其中2例外斜视患者合并内转眼急速上射和(或)下射现象。行单眼或双眼水平肌后徙术后代偿头位、眼球后退及睑裂变小体征均得到改善,术后斜视度数≤10△者11例(85%)。行患眼外直肌后徙术,可使内转眼上射和下射现象得到明显改善。结论:水平肌大量后徙可以使原在位的斜视得到矫正,代偿头位消失或得到明显改善,患眼内转的时候,眼球后退、睑裂变小明显减轻,上射和下射的现象减轻或消失。术前牵拉试验及术中彻底消除牵制因素是手术成功的关键。
AIM： To analyze the surgical methods and effects on Duane＇s retraction syndrome （DRS） .
METHODS： Thirteen cases with DRS were summarized retrospectively. The data were recorded and analyzed, including clinical features, surgical methods and the results.
RESULTS. Twelve cases had only monocular involvement. The number of type I DRS was 9 cases; 3 cases were type Ⅱ DRS with exotropia and 1 case was type Ⅲ DRS. In type Ⅱ, 2 cases with upshoot and /or downshoot phenomenon, Ipsilateral medial rectus or lateral rectus recession, or bilateral medial rectus recession, improved the head compensation position, narrow palpebral fissure and globe retraction, with improvement or elimination of the deviation. After the operation, 11 cases （85%） showed horizontal tropia less than 10 prism diopters. Upshoot and/or downshoot were improved in all of the 2 cases after recessing lateral rectus.
CONCLUSION. Type J DRS with ET （esotropia）, the affected eye MR （medial rectus muscle） must be recessed 6-7mm, type Ⅱ DRS with XT （exotropia）： surgeons must perform large recession the LR （ lateral rectus muscle） of the affected eye. The patients with DRS are treated with appropriate horizontal muscles recession in order to relieve abnormal head position and a significant tropia in primary position, prevent upshoot and downshoot on adduction in patients with DRS. Forcing duction test preoperation and relieving mechanical factors midoperation play important role in successful surgery.
出处
《国际眼科杂志》
CAS
2009年第2期386-388,共3页
International Eye Science
