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目的 :观察下斜肌前移位术治疗先天性上斜肌麻痹原在位垂直性斜视的疗效。方法 :对 39例单侧先天性上斜肌麻痹原在位垂直性斜视≥ 15 Δ 的患者行下斜肌前移位术。手术前后采用三棱镜加交替遮盖法测定斜视度。根据原在位垂直性斜视程度将下斜肌断端移位至下直肌颞侧止端水平后 1mm(15 Δ～ 19Δ) ,止端水平 (2 0 Δ～ 2 4 Δ) ,止端水平前 1mm(≥ 2 5 Δ)处。结果 :原在位垂直斜视度术前平均为 2 1.0 Δ,术后平均为5 .4 Δ,平均矫正 15 .6Δ。结论 :下斜肌前移位术是治疗 >15 Δ 的先天性上斜肌麻痹原在位垂直性斜视的首选术式。
Objective: To observe the effect of inferior oblique anterior muscle shift on orthostatic oblique strabismus in congenital superior oblique palsy. Methods: 39 cases of unilateral congenital superior oblique paralysis of the original vertical strabismus ≥ 15 Δ patients underwent oblique anterior muscle shift. Before and after surgery using prism and alternating cover method to determine the degree of strabismus. According to the original level of vertical strabismus shift the inferior oblique muscle stump to the lower rectus abdominis lateralis level 1mm (15Δ ~ 19Δ), stop level (20 ~ 24), the level of the end 1mm (≥ 2 5 Δ) before. Results: The mean orthophoria before surgery was 2 1.0 Δ preoperatively, with an average of 5.4 after surgery, with an average correction of 15.6 μA. CONCLUSIONS: Down-tilt anterior transposition is the preferred surgical procedure for the treatment of orthostatic oblique strabismus in the presence of> 15 Δ congenital superior oblique palsy.