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目的分析外斜视患者伴有上、下斜肌功能亢进现象的临床特点、机制和治疗效果。设计回顾性病例系列。研究对象13例外斜视伴上、下斜肌功能亢进的患者。方法回顾分析该类患者的斜视患病时间、眼球运动功能、眼球主客观旋转、手术治疗方法和治疗效果。主要指标斜视程度、斜视患病时间、眼球运动功能、双眼视功能。结果13例患者外斜视患病时间平均(19.5±5.9)年,视远外斜视度平均(35.0±5.2)°,视近外斜视度平均(45.4±6.2)°,术前双眼内转功能不足-2～-3,双眼上、下斜肌功能同时亢进+1～+2,眼球主观和客观旋转正常。2例行单眼内直肌缩短联合外直肌后退术,11例行双眼内直肌缩短或联合外直肌后退术。术后1周双眼内转功能正常,上、下斜肌功能亢进现象消失,1例患者术后2个月时复查有单眼下斜肌功能亢进+2。结论部分患病时间较长的大度数外斜视患者伴有内转功能不足,可表现为假性斜肌功能亢进,建议行内直肌缩短术或联合外直肌后退术。(眼科,2007,16:330-333)
Objective To analyze the clinical features, mechanism and therapeutic effect of exotropia in patients with exotropia. Design retrospective case series. Study object 13 cases of strabismus with upper and lower oblique muscle hypertrophy patients. Methods Retrospective analysis of such patients strabismus prevalence, eye movement, eye subjective and objective rotation, surgical treatment and treatment. The main indicators of strabismus, strabismus prevalence, eye movement, binocular vision. Results The mean duration of exotropia was (19.5 ± 5.9) years in all 13 patients, the mean exotropia was (35.0 ± 5.2) °, the average exotropia was (45.4 ± 6.2) °, -2 ~ -3, binocular upper and lower oblique muscle function at the same time + 1 +2, subjective and objective eyeball rotation normal. 2 cases of monocular rectus shortening combined with lateral rectus retraction, 11 cases of binocular rectus shortening or lateral rectus muscle combined with surgery. One week after operation, the function of internal rotation of both eyes was normal, the phenomenon of hyperthyroidism in upper and lower oblique muscles disappeared, and in 1 patient 2 months after operation, monochorial oblique function was found +2. Conclusions Some patients with large exotropia who have a longer duration of exacerbation may have hypogonadism, which may be characterized by pseudo oblique oblique muscle function. It is suggested that the rectus abdominis or the lateral rectus abdominis should be retrospectively performed. (Ophthalmology, 2007, 16: 330-333)