论文部分内容阅读
目的 :探讨分离性垂直偏斜 (dissociatedverticaldeviation ,DVD)的临床特点和治疗方法。方法 :回顾分析 18例DVD病例。结果 :临床特点 :(1)交替遮盖被遮眼向上偏斜 ,与一般斜视的神经支配法则相矛盾 ;(2 )常合并隐性眼震 ;(3)多合并水平斜视 ;(4 )双眼视功能不佳 ;(5 )常合并下转肌或上转肌亢进或麻痹 ;(6 )合并Helveston综合征 (Helveston综合征指DVD和A型外斜及上斜肌过强三者同时存在的综合征 ) ;(7)视力往往良好 ,但也有合并视力减退。治疗方法首选上直肌后徙加后固定缝线。若合并下斜肌亢进 ,则作下斜肌转位术。 18例病人出院时均为正位 ,随诊时间术后 1个月～ 2年 ,18例病人中 15例在第一眼位无明显上斜现象。仅在遮盖一眼时出现轻度上斜。一例术后一年第一眼位 5°上斜 ,较术前斜度明显减少。结论 :当DVD病人上斜明显影响外观时应行手术治疗。
Objective: To investigate the clinical features and treatment of dissociatedvertical deviation (DVD). Methods: A retrospective analysis of 18 cases of DVD cases. Results: The clinical features: (1) Alternate cover the ophthalmic upward deflection, and general strabismus contradict the law of innervation; (2) often associated with latent nystagmus; (3) combined with horizontal strabismus; (4) binocular vision Dysfunction; (5) often combined with the next turn or turn on the muscle hyperthyroidism or paralysis; (6) Helveston syndrome (Helveston syndrome refers to the DVD and A type of oblique and oblique Sign); (7) vision is often good, but also combined with vision loss. The treatment of upper rectus muscle plus the preferred fixed suture. If the merger of the lower oblique hyperthyroidism, then under the oblique muscle transposition. Eighteen patients were discharged at the time of orthostatic, follow-up time of 1 month to 2 years after surgery, 18 patients in 15 cases in the first eye no significant oblique phenomenon. Slight incline only when covered. A case of first eye position after a year 5 ° oblique, significantly decreased compared with the preoperative slope. Conclusions: Surgical treatment should be performed when DVD patients have a clinically significant appearance effect.