Muscle Belly Union for Treatment of Myopic Strabismus Fixus
Muscle Belly Union for Treatment of Myopic Strabismus Fixus
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DOI：
10.1080/09273970902953210
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发表时间：
2009-01-01
期刊：
影响因子：
0.9
通讯作者：
Rajabi, Mohamad
中科院分区：
文献类型：
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作者：
Ahadzadeghan, Iraj;Akbari, Mohammad;Rajabi, Mohamad
目的：评价高度近视伴严重内斜视、低视及外展、上抬受限的患者伴外侧直肌（LR）和上直肌（SR）纵裂的内直肌（MR）萎缩及相应中点的手术愈合效果。方法：对6例重度高度近视性斜视患者进行分析，其中斜视≥90，斜视≥25，斜视≥30。经MRI或CT检查，证实鼻侧左肌偏曲及下侧左肌移位。经影像学检查也发现肌锥的颞上球突出。LR和SR肌肉从插入处到赤道处被分成两半。SR肌的外侧半部分与LR肌的上半部连接。内侧直肌也凹陷。结果：运动能力逐渐改善，至8周时，4例有5 ~ 15个Delta残余内斜视，无低视，外展和上仰轻度受限。其中2例由于内斜视残留明显，我们进行了第二次手术，2个月后内斜视残留轻度。结论：对于高度近视患者，如果MRI或CT扫描显示左、右肌路径偏离，则手术方法是有效的，值得推荐。
Purpose: To evaluate the surgical results of the medial rectus (MR) muscle recession associated with longitudinal splitting of the lateral rectus (LR) and superior rectus (SR) muscles and surgical union of their corresponding midpoints in highly myopic patients with severe esotropia and hypotropia and restricted abduction and elevation. Methods: Six cases of severe high myopic strabismus fixus were considered with more than 90 Delta esotropia and 25 Delta to 30 Delta hypotropia. The nasally deviated SR muscle and inferiorly shifted LR muscle were confirmed by MRI or CT scan. Supratemporal herniation of the globe from the muscle cone was also found by imaging. The LR and SR muscles were split in half from the insertion to past the equator. The lateral half of the SR muscle was united to the superior half of the LR muscle. Medial rectus muscle was recessed also. Results: Motility gradually improved and by 8 weeks in four cases there was 5 Delta to 15 Delta residual esotropia and no hypotropia and mild limitation in abduction and elevation. In two cases due to marked residual esotropia, we performed a second operation, and 2 months later residual esotropia was mild. Conclusion: In highly myopic patients, if the deviant paths of the LR and SR muscles are demonstrated by MRI or CT scan, the surgical method described is effective and recommended.