山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (5): 69-71.doi: 10.6040/j.issn.1673-3770.0.2015.146

• 论著 • 上一篇    下一篇

人工眼位散开术治疗婴儿眼球震颤综合征(附6例报告)

栾亚楠, 郭敬丽, 王利华   

  1. 山东大学附属省立医院眼科中心, 山东 济南 250021
  • 收稿日期:2015-04-09 修回日期:2015-09-21 出版日期:2015-10-16 发布日期:2015-10-16
  • 通讯作者: 王利华,E-mail:wang-glasses@163.com E-mail:wang-glasses@163.com
  • 作者简介:栾亚楠,E-mail:lyn1990@126.com

Outcome of artificial divergence surgery in patients with infantile nystagmus syndrome (6 cases report)

LUAN Yanan, GUO Jingli, WANG Lihua   

  1. Eye Center of Provincial Hospital affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2015-04-09 Revised:2015-09-21 Online:2015-10-16 Published:2015-10-16

PDF (PC)

441

摘要： 目的 探讨人工眼位散开术(ADS)治疗婴儿眼球震颤综合征(INS)的疗效。方法 回顾性病例研究2012年3月至2014年9月采用ADS治疗的有集合阻滞的INS患者。患者均行矫正视力检查,采用整形量角器测量患者注视5 m调节性视标时的代偿头位,采用Worth四点灯检查患者融合功能,采用Titmus立体视图测定其看近立体视锐度,均行三棱镜耐受试验并行双侧内直肌后徙3~4 mm。结果 6例INS患者接受ADS治疗,术后随访3~12月,平均9.8个月。其中,术后代偿头位4例治愈,1例改善,1例无效;术后单眼和双眼矫正视力3例提高,3例无改变;术后立体视锐度2例提高,4例不变。术后眼位过矫1例。结论 ADS对有集合阻滞的INS有较好的疗效,但有发生继发性外斜视的风险。

关键词: 眼球震颤, 眼外肌手术, 婴儿, 治疗结果, 人工眼位散开术

Abstract: Objective To investigate the outcome of artificial divergence surgery in patients with infantile nystagmus syndrome. Methods Six infantile nystagmus syndrome patients with blocking convergence enrolled in out department from March 2012 to September 2014 were retrospectively evaluated. Corrected visual acuity was measured respectively. The head turn (HT) was measured when patients staring at distance fixation using a goniometer. Binocular vision function of patients was evaluated by the Titmus Stereo Test and the Worth Four Light Test in appropriate refractive correction. Prism adaptation test was used in all patients pre-operatively. The amounts of bilateral medial rectus recession was 3-4 mm. Results The average post-operative follow-up period was 9.8 months (range, 3-12 months). After surgery, the HT was eliminated in 4 patients, improved in 1 patient and ineffective in 1 patient. Monocular and binocular corrected visual acuity was improved in 3 patients and unchanged in 3 patients. Stereopsis acuity was improved in 2 patients and unchanged in 4 patients. 1 patient was consecutive exotropia. Conclusion The results of this study preliminarily showed artificial divergence surgery was effective to INS patients with blocking convergence.

Key words: Nystagmus, Artificial divergence surgery, Treatment outcome, Infant

中图分类号: 

  • R777.46
[1] 宗瑶,王利华.婴儿眼球震颤综合征的临床研究进展[J].中华眼科杂志,2013,49(7):653-660. ZONG Yao, WANG Lihua. esearch progress in infantile nystagmus syndrome[J]. Chin J Ophthalmol, 2013, 49(7):653-660.
[2] Kumar A, Proudlock A F, Gottlob I. Management of congenital nystagmus with and without strabismus. In: Pediatric Ophthalmology, Neuro-Ophthalmology, Genetics[M]. New York: Springer, 2010: 153-171.
[3] Kumar A, Shetty S, Vijayalakshmi P, et al. Improvement in visual acuity following surgery for correction of head posture in infantile nystagmus syndrome[J]. J Pediatr Ophthalmol Strabismus, 2011, 48(4):341-346.
[4] Hertle R W, Yang D, Tai Z, et al. A systematic approach to eye muscle surgery for infantile nystagmus syndrome:results in 100 patients[J]. Binocul Vis Strabismus Q, 2010, 25(1):72-93.
[5] Dell'Osso L F. Extraocular muscle tenotomy, dissection, and suture: a hypothetical therapy for congenital nystagmus[J]. J Pediatr Ophthalmol Strabismus, 1998, 35(3):232-233.
[6] American Academy of Ophthalmology. Pediatric Ophthalmology and Strabismus, Basic and Clinical Science Course(2011-2012). 328-329.
[7] Cüppers C. Problems in the surgery for ocular nystagmus[J]. Klin Monatsbl Augenheilkd, 1971,159(2):145-157.
[8] Gräf M. Kestenbaum and artificial divergence surgery for abnormal head turn secondary to nystagmus. Specific and nonspecific effects of artificial divergence[J]. Strabismus, 2002, 10(1):69-74.
[9] Zubcov A A, Stark N, Weber A, et al. Improvement of visual acuity after surgery for nystagmus[J]. Ophthalmology, 1993, 100(17):1488-1497.
[10] Sendler S, Shallo-Hoffmann J, Muhlendyck H. Artificial divergence surgery in congenital nystagmus[J]. Fortschr Ophthalmol, 1990, 87(1):85-89.
[11] Ferris J D, Davies P E J. Nystagmus[M]//In: Strabismus surgery. Elsevier, 2007: 165-170.
[12] Gunter K, von Noorden, Emilio C. Campos. Nystagmus[M]//In: Binocular Vision and Ocular Motility 6th ed. Mosby, 2002: 526-527.
[13] Spielmann A. La mise en divergence artificielle dans les nystagmus congénitaux. A propos de 120 cas[J]. Bull Soc Fr Ophtalmol, 1993, 6(7):571-578.
[14] Alio J L, Chipont E, Mulet E, et al. Visual performance after congenital nystagmus surgery using extended hang back recession of the four horizontal rectus muscles[J]. Eur J Ophthalmol, 2003, 13(6):415-423.
[15] Lee J. Surgical management of nystagmus[J]. J R Soc Med, 2002, 95:238-241.
[16] Hertle R W. Nystagmus in Infancy and Childhood[M]//In: Pediatric Ophthalmology. Springer, 2009: 251.
[17] Gräf M, Droutsas K, Kaufmann H. Surgery for nystagmus related head turn: Kestenbaum procedure and artificial divergence[J]. Graefes Arch Clin Exp Ophthalmol, 2001, 239(4):334-341.
[18] Spielmann A C. Progression of subjective refraction after artificial divergence surgery and its relation to a possible myopic spasm[J]. J Fr Ophtalmol, 2003, 26(1):25-30.
[1] 沈勤峰,沈小燕,朱荣强,蒋斐斐,郎军添. 鼻内镜下中鼻甲功能性部分切除治疗慢性鼻窦炎76例分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 82-85.
[2] 马钊恩, 翟锦明, 廖礼兵, 杨震. 咽鼓管球囊扩张术治疗慢性分泌性中耳炎的短期疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 54-56.
[3] 张杰,陈雪梅,许安廷. 超声刀扁桃体切除术与低温等离子扁桃体切除术的对比研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 95-100.
[4] 刘洁,施陈燕,张治军. 糠酸莫米松鼻喷剂联合玉屏风颗粒可提高儿童腺样体肥大疗效[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 73-76.
[5] 刘俊茹,高英恺,杨杨,王俊菊,刘存军. 低温等离子刀切除舌根增生性肿物40例报告[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 83-84.
[6] 王雅宁,耿博,李百彦,崔朝阳,王启荣. 鼻咽癌放疗后颅底骨感染坏死的治疗体会[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 42-45.
[7] 刘洪, 刘天悦, 王春娇, 王娟. 改进软腭牵拉暴露鼻咽手术治疗腺样体肥大[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 89-90.
[8] 王永福, 徐永向, 于军, 宇雅平, 陈晓华. 茎突综合征30例手术治疗临床分析[J]. 山东大学耳鼻喉眼学报, 2014, 28(6): 9-10.
[9] 马翔, 郭敬丽, 王利华. 双眼外直肌后徙术治疗儿童类似分开过强型间歇性外斜视22例[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 62-65.
[10] 周荣金, 王俊国. 鼻咽部肌上皮癌1例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 33-34.
[11] 郭敬丽， 王琪， 王利华， 马翔， 李琳. 婴儿眼球震颤综合征合并斜视的手术疗效[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 67-70.
[12] 刘全，吕传桢. 中西医结合治疗儿童慢性鼻窦炎临床疗效观察[J]. 山东大学耳鼻喉眼学报, 2014, 28(1): 46-47.
[13] 许风雷1，夏明2，钱晔2，孙睿杰2，刘大昱2，魏伟3. 婴儿口咽部毛息肉11例[J]. 山东大学耳鼻喉眼学报, 2013, 27(6): 63-65.
[14] 万京明. 手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征80例[J]. 山东大学耳鼻喉眼学报, 2013, 27(1): 10-11.
[15] 李树华，石洪金，董卫东，吴大海. 喉源性阻塞性睡眠呼吸暂停低通气综合征的临床观察[J]. 山东大学耳鼻喉眼学报, 2012, 26(6): 1-3.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发