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目的探讨治疗以水平面转为主的先天性眼球震颤混合型代偿头位的手术矫正方法。设计回顾性病例系列。研究对象2003-2008年在河北省邢台眼科医院接受治疗的以水平面转为主的先天性眼球震颤混合型代偿头位的患者11例。方法采用后退双眼慢相侧的一对配偶肌(内直肌后退6mm,外直肌后退8mm),同时加强快相侧的一对配偶肌(外直肌缩短9mm,内直肌缩短7mm)的手术方法。术后随访6～20个月。主要指标双眼正前方注视视力,水平面转、下颌上抬或内收、头倾的程度。结果术后最后一次随访时双眼正前方注视最佳矫正视力提高均≥2行。术后混合型代偿头位完全消失或≤10°者9/11例,其中1例头位过矫。代偿头位扭转角≤15°者1例,仍残留25°水平面转头位者1例。结论通过单纯的减弱和加强水平肌肉的后退缩短手术进行中间带移位即可明显改善水平面转为主的先天性眼球震颤的混合性代偿头位,并能提高正前方双眼视力。
Objective To investigate the surgical treatment of congenital nystagmus mixed compensatory head with horizontal rotation. Design retrospective case series. Subjects Eleven patients with congenital nystagastrus mixed compensatory head position who were treated at Xingtai Eye Hospital of Hebei Province from 2003 to 2008 were enrolled. Methods A pair of spouse muscles (retreating 6mm in rectus abdominis and 8mm in rectus abdominis) in retreating retina and a pair of splenic muscles (9mm in rectus abdominis and 7mm in rectus abdominis) Surgical methods. Follow-up 6 to 20 months after operation. Main indicators Eyes are watching in front of eyesight, horizontal rotation, mandibular uplift or adduction, the degree of head tilt. Results The best corrected visual acuity was ≥2 lines in the front of the eyes after the last follow-up. Postoperative mixed compensatory head completely disappeared or ≤ 10 ° 9/11 cases, of which 1 case of head position overcorrection. One patient with compensated head twist ≤15 ° and one patient with 25 ° horizontal head still remained. Conclusions The median compensatory head position of congenital nystagmus with horizontal rotation can be significantly improved by simply shifting the medial shift with shortening and strengthening horizontal muscle retraction and shortening operation, and can improve the visual acuity of both eyes in front.