摘要
目的:探讨下斜肌后固定术(IOBT)在伴有轻中度下斜肌功能亢进的V型斜视中的治疗效果。方法:前瞻性研究。选择2018年1月至2020年4月在徐州市第一人民医院行IOBT或者部分切除术的外斜V征患者40例,按照随机数字表法将患者随机分为IOBT组和下斜肌部分切除术(IOMYE)组,各20例。IOBT组行双眼IOBT+水平斜视矫正术,IOMYE组行双眼IOMYE+水平斜视矫正术。比较2组手术前后水平斜视度(HD)、V值、黄斑视乳头夹角(FDA)及下斜肌功能(IOA)等变化情况。随访时间为6个月。数据采用配对样本t检验、独立样本t检验进行分析。结果:IOBT组17例(85%)治愈,IOMYE组14例(70%)治愈。IOBT组手术前后FDA变化差异无统计学意义(t=1.313,P=0.205)。2组间手术前后FDA、IOA、V值变化值的差异均有统计学意义(t=-11.788,P<0.001;t=-3.701,P=0.001;t=-8.519,P<0.001)。IOBT组术后无一例过矫为A征。IOMYE组6例V征过矫为A征,IOA轻度不足8例。结论:IOBT术可安全、有效地治疗伴轻中度下斜肌亢进的外斜V征,是传统下斜肌减弱术的补充。
Objective:To investigate the effect of the application of the inferior oblique muscle belly transposition(IOBT)in V-pattern strabismus with mild-to-moderate inferior oblique overaction(IOOA).Methods:This was a prospective study.From January 2018 to April 2020,40 patients(80 eyes)with V-pattern exotropia with minimal-to-moderate IOOA who underwent IOBT or inferior oblique myectomy(IOMYE)in Xuzhou No.1 People's Hospital were randomly divided into two groups:An IOBT group(n=20)and an IOMYE group(n=20).In addition to horizontal strabismus correction,the patients underwent IOBT in the IOBT group and inferior oblique myectomy(IOMYE)in the IOMYE group.There was a 6-month follow-up period.Horizontal deviation(HD),V pattern,foveal disc angle(FDA)and inferior oblique action(IOA)were analyzed before and after the operation.Data were analyzed using paired t test and independent t test.Results:Seventeen(85%)patients were cured in the IOBT group and 14(70%)in the IOMYE group.There was no significant difference(t=1.313,P=0.205)in FDA before and after surgery in the IOBT group.The differences in changes in FDA,IOA and V pattern between the two groups were statistically significant(t=-11.788,P<0.001;t=-3.701,P=0.001;t=-8.519,P<0.001).Postoperatively,the IOBT group achieved satisfactory results,without overcorrection to an A pattern.In the IOMYE group,6 patients were overcorrected to A pattern and 8 patients had mild underaction of the inferior oblique.Conclusions:IOBT can successfully treat the V pattern in patients with mild-to-moderate IOOA.It is a supplement to traditional inferior oblique muscle weakening.
作者
司明宇
邵新香
范可顺
Mingyu Si;Xinxiang Shao;Keshun Fan(Department of Ophthalmology of Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University,Xuzhou No.1 People's Hospital,the Affiliated Hospital of China University of Mining and Technology,Xuzhou 221001,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2021年第2期120-127,共8页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
徐州市科技计划项目(KC19166)。
关键词
下斜肌后固定术
V征
下斜肌功能亢进
下斜肌功能不足
inferior oblique muscle belly transposition
V pattern
inferior oblique muscle overaction
underaction of the inferior oblique muscle
