作者2年间收治7例先天性下直肌缺如,并综合国内文献中的18例共25例27眼。上斜度平均≥50~Δ,合并水平斜视者以外斜多见,外斜度≥2~Δ,眼球不能下转。可合并眼睑、角膜、葡萄膜和视神经等眼部发育异常,术中可见内外、上直肌附着处增宽,移位或眼肌部分纤维化等。应用现代显微血管分离技术加内外直肌部分肌束交叉移位术一次矫正双眼下直肌缺如1例,随访半年,无眼前段缺血症状。 The authors treated 7 cases of congenital inferior rectus absent 2 years, and comprehensive domestic literature 18 cases a total of 25 cases 27 eyes. On the average slope of ≥ 50 ~ Δ, combined horizontal strabismus outside the ramp more common, external gradient ≥ 2 ~ Δ, the eye can not be transferred. Can be combined eyelid, cornea, uveal and optic nerve and other eye dysplasia, intraoperative and external visible, the rectus abdominis widened, displacement or partial ocular muscle fibrosis. Application of modern microvascular separation technology plus internal and external rectus muscle bundles cross-shift a correction of bilateral inferior rectus absent one case, followed up for six months, no anterior segment ischemic symptoms.