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目的 :探索治疗分离性垂直偏斜 (DVD)的最佳手术方式。方法 :对 10 3例 192眼DVD患者应用上直肌后退术 ,上直肌后退联合后固定缝线术 ,下斜肌转位术及上直肌后退联合下斜肌转位术进行随机分组治疗。结果 :后退组近期效果良好者 6 7.39% ,远期 5 8.82 % ,P <0 .0 0 5。后退 +后固定组近期效果良好者 82 .6 9% ,远期 80 .5 6 % ,P>0 .5。下斜肌转位组近期效果良好者 6 5 % ,远期 5 6 .6 7% ,P >0 .0 0 1。后退 +下斜肌转位组近期效果良好者 83.72 % ,远期 81.2 5 % ,P >0 .1。结论 :单独上直肌后退和下斜肌转位术治疗DVD效果不佳 ,后退 +后固定缝线组及后退 +下斜肌转位组效果可靠 ,后者尤其适用于合并下斜肌亢进患者
Objective: To explore the best surgical approach to the treatment of detached vertical deviation (DVD). Methods: A total of 192 patients (192 eyes) were enrolled in this study. The upper rectus superior rectus, the lower rectus posterior fixed suture, the inferior oblique muscle transposition and the superior rectus combined with the inferior oblique muscle transposition were randomly divided into two groups . Results: In the receding group, the recent good effect was 6 7.39%, long-term 5 8.82%, P <0.05. Back + fixed group the recent good results 82.69%, long-term 80.56%, P> 0 .5. The inferior oblique transposition group had a good effect of 65%, long-term 56.67%, P> 0.05. In the retrospective and inferior oblique transposition group, 83.72% were good in the short term and 81.2% in the long term, P> 0 .1. Conclusion: The superior rectus and inferior oblique muscle transposition alone can not treat DVD effectively, and the effect is good in the combination of retrograde + posterior fixation suture group and retrograde + inferior oblique muscle transposition group, and the latter is especially suitable for the patients with inferior oblique hyperactivity