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目的探索伴有下斜肌亢进的分离性垂直偏斜的有效手术方式。方法对54例95眼伴有下斜肌亢进的DVD患者应用下斜肌后徒转位法。依据上斜程度确定下斜肌新附着点的位置。上斜小于6△16眼转位到下直肌止端水平后1mm;上斜7～11△45眼,转位到下直肌止端水平;上斜大于11△34眼,前移到下直肌止端前1mm或2mm(1mm25眼,2mm9眼)其中1例单眼上斜50～80△者联合同侧上直肌后徙6mm,对合并水平斜视者,则采用水平直肌后徙和缩短术同时矫正水平斜视。结果术后满意者93眼(97.89%),好转者2眼(2.11%),无1例无效者。95眼术后下斜肌亢进均消失,无1例上转受限者。结论下斜肌后徒转位术是治疗伴有下斜肌亢进分离性垂直斜视的有效手术方式。
Objective To explore an effective surgical approach to the separation of vertical deviation with inferior oblique hypertrophy. Methods Fifty-four patients (95 eyes) with DVD with hypo-elevation of the lower oblique were subjected to inferior oblique muscular transfer. Determine the location of the new attachment point of the inferior oblique muscle according to the degree of upward inclination. Upper oblique less than 6 △ 16 transposition to the lower rectus abdominis level after 1mm; oblique 7 ~ 11 △ 45 eyes, transposition to the lower rectus abdominis level; upper oblique greater than 11 △ 34 eyes, move forward to the next Rectus abdominis 1mm or 2mm (1mm25 eyes, 2mm9 eyes) of which 1 case of monocular oblique 50 ~ 80 △ combined ipsilateral upper rectus muscle reset 6mm, the merger horizontal strabismus, the use of horizontal rectus muscle resettlement and Shortening at the same time correcting horizontal strabismus. Results 93 patients (97.89%) were satisfied after operation, 2 eyes (2.11%) improved and no one was ineffective. 95 cases of postoperative oblique hyperparathyroidism disappeared, no one on the transfer of limited persons. Conclusion Posterior oblique transposition surgery is an effective surgical method for the treatment of vertical oblique vision associated with inferior oblique hyperthyroidism.