斜視之手術治療第八篇斜視手術效果與眼軸長度的關係

Surgical Treatment of Strabismus Ⅷ. the Relation between the Surgical Effect and the Axial Length

林惠朗(Huey-Lan Lin) ； 蔡宜倫(I-Lun Tsai)

《中華民國眼科醫學會會刊》 28卷1期 (1989/05) Pp. 242-252

https://doi.org/10.30048/ACTASOS.198905.0044

摘要

本篇對173個斜視病人，以線性廻歸來分析每單位眼肌的手術效果（即手術值）與眼軸長度的關係，並與Gillies和Hughes在1984年發表的以眼軸及偏位角度米預估手術需要量的方法作比較。同時探討眼肌術前及術後附着點的位置與手術值的關係。統計的結果發現眼軸長度與每單位眼肌的手術效果間沒有相關(r^2=0.001)。依循Gillies formula規則變化的病例，在內斜視有48.8%，在外斜視只有31.5%。內直肌在內斜視及外直肌在外斜視的附着點都會隨著眼軸之增長而移後，但眼肌附着點的位置並不會影響手術值。術後眼肌附着點位於functional equator之後的病例，手術值也沒有比位在functional equator之前者大。

並列摘要

The purpose of this paper is to evaluate the surgical effect per millimeter of surgery influenced by the axial length of eyeball. The results were compared with the results postulated by Gillies in 1984; Other factors that changed with the axial length, such as the location of preoperative muscle insertion, the relation between postoperative mucscle insertion and functional equator, were also discussed.
Contrary to the general concept, no correlation was found between the surgical effect per millimeter of surgery and the axial length (r^2=0.01), only 48.8% of esotrope and 31.5% of exotrope follow the rule of the Gillies formula.
Although the distance from limbus to insertion of the medial rectus muscle in esotropia and the lateral rectus muscle in exotropia were noted to be sited more posteriorly as the axis lengthens, the surgical effect is not affected by the distance of the muscle insertion either from the limbus or from the functional equator.
In this paper, no difference of surgical efects were found whether the postoperative muscle insertions were placed posterior to the functional equator or anterior to it. This may be supposed that it is the tangential point of the muscle to the eyeball, not the functional equator, is the end point of muscle recession. Of course, further investigation is necessary for this supposition.

並列關鍵字

axial length ； functional equator ； muscle insertion ； tangential point