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1、V型外斜視的臨床特征和手術(shù)治療作者：陶利姐，王平，土曦瑯,楊慧玲，郭燕單位：中國湖南省長(zhǎng)沙市，湖南省兒童醫(yī)院眼科湖南省兒童眼視光弱視斜視防治中心【摘要】目的：探討V型外斜視的臨床特點(diǎn)和手術(shù)方法及療效方法：分析200301/200707在我院行手術(shù)治療的93例V型外斜視患者，其中男51例，女42例，年齡4?27(平均13.2)歲,術(shù)后隨訪吋間為6mo?4n,V征向上向下注視的斜視度Z差最小為15A,最大相差100△，其中15?50△者85例，＞50△者8例，第一眼位斜視角在20?110A,術(shù)前行同視機(jī)檢查有雙眼單視功能者18例。手術(shù)根據(jù)有無斜肌異常和V征的程度，在水平斜視矯止的
2、同時(shí)，選擇下斜肌切斷或部分切除，直肌附著點(diǎn)垂直移位、及下斜肌部分切除并水平直肌垂直移位三種術(shù)式。結(jié)果：釆用下斜肌斷腱或部分切除術(shù)和水平直肌附著點(diǎn)移位均取得滿意效杲，卜-斜肌斷腱或部分切除術(shù)適應(yīng)于下斜肌亢進(jìn)的外斜V型，垂立肌移位術(shù)適應(yīng)因無下斜肌亢進(jìn)的外斜V征，術(shù)后第一眼位止位者84例，V征消失者87例，雙眼視功能恢復(fù)者達(dá)49例。結(jié)論：V型外斜視是一種常見的斜視類型，常合并水平斜視，發(fā)病原因以斜肌功能異常為主，可根據(jù)病因選擇不同手術(shù)方式，手術(shù)不僅可以矯正眼位，而H冇利川雙眼單視功能的建立?！娟P(guān)鍵詞】V征外斜視;臨床特點(diǎn);手術(shù)Cliniccharacteristicsandsurg
3、icalmanagementinVpatterndeviationLiJuanTao,PingWang,XiLangWang,HuiLingYang,YanGuo,ZhiGangXiaoDepartmentofOphthalmology,theHunanChildrensHospital,TheCenterforChildrenOptometryAmbliopiaandStrabismusofHunanProvince,Changsha410007,HunanProvince,ChinaAbstractAIM:Tostudythecliniccharacteristics,s
4、urgicaltreatmentandpostoperativeeffectofVpatterndeviation?METHODS:Thesurgicaleffectsof93patientswithvpatterndeviation(male51,female42),treatedinourhospitalduringJanuary2003toJuly2007,withagesrangingfrom4to27years(meaning13.2years)wereanalyzed?Followuptimeaftersurgerywas648months.Viewingthed
5、ifferencesbetweensuperiorstrabismusanglesandinferiorstrabismusangles,85casesofaskantdifferencewere15A50A,and8casesofaskantdifferenceweremorethan50Thesmallestaskantdifferencewas15A,thegreatestwas100A.Thecasesofaskantwerebetween20△?100Aatprimai-ypositionofeye.Eighteencaseshadbinocularfunction
6、bysynoptophorefest.Accordingtodysfunctionofobliquemuscleandlevelofvpattern,patientsweretreatedwithhorizontalrectusverticaltransporting,completelyorpartlyinferiorobliquereductionorhorizontalrectusverticaltransportingcombinedwithinferiorobliquereduction?RESULTS:Patientstreatedwithhorizontalre
7、ctusverticaltransporting,partlyinferiorobliquereductionhadsatisfiedresults.Thecases,withvexotropiacomplicatingoveractiondegreesofinferiorobliquemuscle,shouldbetreatedwithpartlyinferiorobliquereduction.Ifnotcomplicatingdysfunctionofobliquemuscles,casewere
