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目的探讨儿童先天性眼球震颤的手术方法及手术治疗效果。方法回顾性分析采用手术治疗的儿童先天性水平性眼球震颤43例。冲动型29例采用Anderson法矫正;钟摆型14例行双眼内、外直肌后巩膜固定术,其中7例合并斜视者,联合双眼内直肌或外直肌后徙术。结果手术后正前方眼球基本不颤12例(27.91%),减轻29例(67.44%),无变化2例(4.65%)。代偿头位消失11例(39.29%),减轻17例(60.71%)。41例视力提高。11例外斜视5例矫正为正位,6例欠矫;2例外上斜无改善;1例内斜视欠矫。无任何并发症发生。结论儿童先天性眼球震颤,根据不同的眼震类型可选择不同的手术方式,钟摆型采用直肌后巩膜固定术,冲动型采用Anderson法矫正,大多数病例可获得好的疗效。
Objective To investigate the surgical methods and surgical treatment of congenital nystagmus in children. Methods Retrospective analysis of surgical treatment of congenital horizontal nystagmus in 43 cases. Impulsive type 29 cases were corrected by Anderson method; pendulum type 14 cases of binocular and posterolateral muscle scleral fixation, including 7 cases of strabismus, combined with bilateral rectus or lateral rectus muscle surgery. Results There was no fibrillation in 12 eyes (27.91%), reduction in 29 eyes (67.44%) and no change in 2 eyes (4.65%). 11 cases (39.29%) disappeared in compensation head, 17 cases (60.71%) alleviated. 41 cases of vision improvement. Eleven cases of strabismus correction were positive, 6 cases of undercorrection; 2 cases without improvement of upper oblique; 1 case of less than correction of strabismus. No complications occurred. Conclusions Children with congenital nystagmus may choose different surgical methods according to different types of nystagmus. Posterior rectus sclera fixation is used for pendulum type. Anderson method is used for impulse type correction. Most cases have good curative effect.