论文部分内容阅读
目的探讨分离性垂直斜视(Dissociated vertical deviation,DVD)的有效手术方法。方法对40例58眼DVD根据双眼视力状况,双眼上斜程度及合并其他类型斜视进行综合分析,设计手术。双眼DVD不伴有下斜肌功能亢进者,若双眼视力良好,且上斜程度相等者做双眼上直肌等量后徙术;双眼上斜程度不等者做双眼上直肌不等量后徙或先做上斜明显眼手术。若单眼弱视明显先做弱视眼手术。单眼DVD,仅做单眼手术。伴有下斜肌功能亢进者做下斜肌缩短4-5mm后徙转位术。DVD合并水平斜视者,尽可能一期完成。否则,先矫正水平斜视,6个月后行DVD矫正术。上直肌后徙按1mm矫正3Δ计算,最大后徙量为8mm。结果40例58眼DVD,50眼满意(85．21％), 8眼好转(13．79％)。结论对不伴有下斜肌功能亢进的DVD行上直肌超常量后徙术疗效满意;伴有下斜肌功能亢进的DVD行下斜肌缩短4-5mm后徙转位术疗效满意。
Objective To investigate the effective surgical method of dissociated vertical deviation (DVD). Methods 40 cases of 58 cases of DVD according to binocular visual acuity, binocular tilt and other types of strabismus for a comprehensive analysis of design surgery. Binocular DVD is not associated with hypothalamic hyperthyroidism, if the binocular vision is good, and the same degree of tilt on the rectus quadrangle after the same amount of resettlement; eyes do not have the degree of tilt on the other side of the upper rectus unequal amount Migration or to do the first obvious oblique surgery. If monocular amblyopia obviously do amblyopia eye surgery. Single-eye DVD, only monocular surgery. Accompanied by lower oblique muscle hyperthyroidism who do shortening 4-5mm oblique repositioning surgery. DVD merge horizontal strabismus, as far as possible to complete a. Otherwise, the first correction of horizontal strabismus, DVD surgery after 6 months. Upper rectus muscle reset by 1mm correction 3Δ calculation, the maximum amount of post-recuperation is 8mm. Results 40 cases of 58 eyes DVD, 50 eyes satisfied (85.21%), 8 eyes improved (13.79%). Conclusions The outcome of rectus ablation of rectus abdominis rectus on DVD is not satisfactory with no correction of inferior oblique muscle function. The shortening of 4-5 mm of inferior oblique muscle of DVD with inferior oblique muscle function is satisfactory.