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雙眼內直肌退縮與單眼直肌之退縮―切除術對內斜視治療之比較
Bimedial, Recession vs Recession-Resection on Treatment of Esotropia
摘要
本文將榮總自民國67年8月至民國75年11月間94位共働性內斜視病人接受雙眼內直肌退縮手術與單眼直肌退縮一切除手術結果作一比較與分析。接受單眼直肌退縮一切除手術者，在手術前後含弱視眼居多，眼位矯正較好(54%)，但兩眼單一視覺機能較差(27%)，手術後對眼球運動有障得者占38%。而接受雙眼內直肌退縮手術病例，在手術前後均經過一段時期的弱視治療（平均5.76個月），再施行手術，兩眼眼球運動及平衡感較好，正常眼位維持穩定，有53%獲得較好視力及立體感，但對斜視矯正較差，治癒40%，若加上手術後輔助療法，治癒率提高至62%，有17.6的病人需再施行一次手術以矯正剩餘之斜角度。
關鍵字
無資料並列摘要
Of 240 unilateral medial rectus recessions-lateral rectus resections and bilateral medial recessions performed for concomitant esotropia from August 1978 to November 1986, a total of 94 met the requirements for a comparative study. Preoperative and postoperative amblyopia was more prevalent in the monocular recession- resection population. Postoperative ocular alignment was better and need for further strabismus surgery was less (11%). The cure rate was 54%, however its functional cure rate was only 27% and 38% of patients caused ocular movement disturbance. In cases of bimedial recession patients, the cure rate was less (40%) and 17.6% of cases needed further surgery. After postoperative adjuvant therapy, the cure rate increased to 62% and functional cured rate was 53%. Only one case was overcorrection. A significantly greater use of occlusion in the patient with amblyopia was noted. Postoperative adjuvant therapy is commonly necessary for decreasing residual esotropia and increased binocular function.