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作者对先天性下直肌缺如采用下斜肌代下直肌手术时,应用了“人工滑车”取得了较好效果,报告如下:手术方法:术前准备及麻醉同一般眼外肌手术,首先行上直肌后徒6～7mm.用缝线标记角膜缘6点位.用小齿镊在角膜缘外将眼球拉转向鼻上方,切开颞下方结膜3～5mm,用中钩钩出外直肌并用1号线环形固定牵拉之.按6点标记充分探查下直肌以确定下直肌是否存在,证明确无下直肌者,用小斜视钩钩出下斜肌充分分离肌周组织,在近外直肌下缘部缝一双套环线,后在斜肌的缝线止端侧剪断下斜肌.采用不吸收线或异体巩膜做一直径大于下斜肌2倍的环,并套在下斜肌上备用,下斜肌断端移位固定在6点角膜缘下4～5mm部位.用缝线将套在下斜肌上的环(人工滑车)固定在眶下缘中点后10～15mm处的骨膜上,观察眼位后缝合结膜切口,双眼包扎.
The author of the congenital inferior rectus abscess inferior oblique muscle rectus abdominis surgery, the application of a “manual pulley” achieved good results, the report is as follows: surgical methods: preoperative preparation and anesthesia with the same general external muscular surgery, First line of rectus abductor 6 ~ 7mm. Suture marked corneal margin 6 points. With a small tooth tweezers in the corneal limbus will pull the eyeball above the nose, cut open temporal below the conjunctiva 3 ~ 5mm, with a hook in the hook Rectus muscle and the ring with a fixed line traction by 6 points marked by full exploration of the lower rectus muscle to determine the presence of lower rectus muscle, confirmed no lower rectus, with a small strabismus hook off the lower oblique muscle full separation of the muscular circumference Tissue, near the outer rectus muscle seams a pair of looped line, and then in the oblique end of the suture to cut off the oblique side of the non-absorption line or sclera with a diameter larger than the lower oblique 2 times the ring and Set in the lower oblique on standby, shift the lower oblique fixed at the 6-point limbus corneal edge 4 ~ 5mm parts. Set the ring in the lower oblique muscle (artificial pulley) fixed in the middle of the edge of the infraorbital 10 ~ 15mm Department of the periosteum, observe the position after suture conjunctiva incision, binocular bandaging.