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麻痺性斜视之手术治疗在国內尚未普遍开展,亦无文献报导。本文着重探讨对垂直斜视有关的斜肌手术。至于麻痺性內外斜视仅有肌肉功能轻度不足者,其手术方法与一般共同性斜视相似,故不论述。麻痺性斜视分为先天性(包括婴儿期)与后天性眼肌麻痺。先天性之主要病因为肌肉神经发育异常或产伤及生后早期之周身疾患。后天性之病因颇复杂,主要为外伤、周身疾患、血管疾患、神经系统疾患、肿瘤、新陈代谢异常、外来毒物及家族性退化性变等。对于早期的后天性麻痺性斜视,要针对病原进行治疗,如原发病已癒而肌肉麻痺尚不恢复,往往须手术矫正。对于先天性眼肌麻痺,一般只能用手术纠正。对麻痺性斜视,尤其是对垂直运动的眼肌施行手术,人们往往有所顾虑,因为垂直运动眼肌共八个,相互协调,功能较为复杂,如处置不当,易招致功能紊乱,且垂直跟肌之解剖联属远较内外直肌复杂,手术效果不易估计。兹对手术问题略论如下:
Surgical treatment of paralytic strabismus has not been carried out widely in China and there is no literature report. This article focuses on vertical oblique strabismus surgery. As for paralytic exotropia, only mild muscle function deficiencies, and its surgical methods similar to the general common strabismus, it does not matter. Paralytic strabismus is divided into congenital (including infancy) and acquired ophthalmoplegia. The main cause of congenital muscular dysplasia or birth injury and early post-natal disease. The causes of acquired immunity are complex, mainly trauma, systemic diseases, vascular diseases, nervous system disorders, tumors, metabolic abnormalities, foreign toxins and familial degenerative changes. For early acquired paralytic strabismus, to be treated for the pathogen, such as the primary disease has been recovered and muscle paralysis has not yet recovered, often requiring surgical correction. Congenital ophthalmoplegia, generally only with surgery to correct. Paralytic strabismus, especially for the vertical movement of the eye muscle surgery, people often have some concerns, because the vertical movement of the ocular muscles a total of eight, coordination, more complex functions, such as improper handling, easy to cause dysfunction, and vertical with the Anatomy of the muscle far more complex than the inside and outside the rectus muscle, the effect of surgery is not easy to estimate. Here are a few questions about surgery: