斜視之手術治療　第二篇　下斜肌減弱手術對水平斜視開刀效果的影響

Surgical Treatment of Strabismus. Ⅱ. Effect of Inferior Oblique Weakening Procedures on Horizontal Strabismus Surgery

林惠朗(Huey-Lan Lin)

《中華民國眼科醫學會會刊》 25卷2期 (1986/05) Pp. 381-388

https://doi.org/10.30048/ACTASOS.198605.0070

摘要

22 patients who had either orthophoria or small angle heterotropia were treated only with inferior oblique myotomy or myectomy to correct their over-active inferior oblique muscles. After the operation, 27.3% of them maintained their original eye position. 50% had 3-10∆ shift to the nasal side and 22.7% had 2-6∆ shift to the temporal side. It was concluded that little if any change occurred in the horizontal position of the eye following such a procedures for weakening the inferior oblique muscle.
258 esotropic patients were divided into three groups. Of these. 187 patients had esotropia without any inferior oblique overactivity. 15 patients who had esotropia with an overactive inferior oblique muscle had no operation done on it. 56 esotropic patients had combined operations for horizontal strabismus and overactive inferior oblique muscles. The surgical results of the horizontal correction of these three groups were calculated and compared by computer. No statistical difference was found between them. This means the weakening of the inferior oblique muscle had no significant effect on the surgical result of horizontal operation in esotropic patients.
Another 244 exotropic patients were also divided into three groups. Of these, 177 patients had pure exotropia without any inferior oblique overactivity. 22 patients who had exotropia with inferior oblique overactivity had no operation done on their inferior oblique muscle, 45 patients had a combined operation for their horizontal strabismus and overactive inferior oblique muscle. The surgical results of the horizontal correction of these three groups were also calculated and compared by computer. The average amount of correction of the group whose inferior oblique muscle was operated on was 3.21∆ per millimeter of recession-resection operation. This compared with 2.74∆ correction per millimeter in the two groups whose inferior oblique muscle were not operated on. The difference was statistically significant (p＜0.05). No statistical difference was noted between the group without overactive inferior oblique muscle and the group whose overactive inferior oblique muscle that were not operated. Also no statistical difference was noted between the groups in which either one or two inferior oblique muscles were operated on. We came to the conclusion that operation for weakening of the inferior oblique muscle could augment the surgical results of the horizontal correction operation done on exotropic patients.

並列摘要

22 patients who had either orthophoria or small angle heterotropia were treated only with inferior oblique myotomy or myectomy to correct their over-active inferior oblique muscles. After the operation, 27.3% of them maintained their original eye position. 50% had 3-10∆ shift to the nasal side and 22.7% had 2-6∆ shift to the temporal side. It was concluded that little if any change occurred in the horizontal position of the eye following such a procedures for weakening the inferior oblique muscle.
258 esotropic patients were divided into three groups. Of these. 187 patients had esotropia without any inferior oblique overactivity. 15 patients who had esotropia with an overactive inferior oblique muscle had no operation done on it. 56 esotropic patients had combined operations for horizontal strabismus and overactive inferior oblique muscles. The surgical results of the horizontal correction of these three groups were calculated and compared by computer. No statistical difference was found between them. This means the weakening of the inferior oblique muscle had no significant effect on the surgical result of horizontal operation in esotropic patients.
Another 244 exotropic patients were also divided into three groups. Of these, 177 patients had pure exotropia without any inferior oblique overactivity. 22 patients who had exotropia with inferior oblique overactivity had no operation done on their inferior oblique muscle, 45 patients had a combined operation for their horizontal strabismus and overactive inferior oblique muscle. The surgical results of the horizontal correction of these three groups were also calculated and compared by computer. The average amount of correction of the group whose inferior oblique muscle was operated on was 3.21∆ per millimeter of recession-resection operation. This compared with 2.74∆ correction per millimeter in the two groups whose inferior oblique muscle were not operated on. The difference was statistically significant (p＜0.05). No statistical difference was noted between the group without overactive inferior oblique muscle and the group whose overactive inferior oblique muscle that were not operated. Also no statistical difference was noted between the groups in which either one or two inferior oblique muscles were operated on. We came to the conclusion that operation for weakening of the inferior oblique muscle could augment the surgical results of the horizontal correction operation done on exotropic patients.

並列關鍵字

inferior oblique weakening procedures ； En bloc recession ； multiple regression