手术治疗Duane眼球后退综合征的疗效分析

摘要

目的 探讨Duane眼球后退综合征(DRS)的临床特征,鉴别诊断以及手术治疗的方法和效果.方法 对自2003至2010年16例因DRS行手术治疗的患者资料进行回顾性总结和分析,观察项目包括患者的性别和年龄、DRS类型和临床表现、手术治疗方式和效果.结果 16例患者中,男7例,女9例.左眼受累11例,右眼受累5例,左眼易患病.I型10例;Ⅱ型2例;Ⅲ型4例.12例患者合并内转眼急速上转和(或)下转现象,多为DRS外斜视者.全部16例患者均行单眼内直肌和(或)外直肌后徙术或双眼内直肌后徙术,其中有例行上直肌后徙术,4例行下斜肌切断术,术后均取得满意效果.结论 典型的DRS诊断并不困难,不同类型DRS的临床表现不同,内转眼上、下转现象多见于DRS外斜视者,详细的术前检查和合理的手术方案设计对眼球后退综合征的治疗具有重要意义.%Objective To analyze the clinical manifestations, differential diagnosis, and the methods and effects of surgical management on Duane's RetraCtion Syndrome( DRS ). Methods 16 Cases with DRS in 2003 - 2009 were reviewed retrospectively. The data, including sex, age, clinical types, manifestations, surgical methods and outcomes, were recorded and analyzed. Results 7 males and 9 females were included. 11Cases were involved in the left eye; 5Cases were involved in the Right eye. The number of Cases with Type Ⅰ DRS was 10.2 Cases were Type Ⅱ DRS and 4 Cases were Type Ⅲ DRS.In12 Cases with upshoot and/or downshoot phenomenon,most of them were associated with exotropia . All the patients underwent ipsilateral medial rectus , lateral rectus recession, or bilateral medial rectus recession . 2 patients were treated by recession of superior rectus muscle, and 4 patients were treated by nyectomy of the inferior oblique muscle. All patients were improved post-operatively. Conclusion Different type of DRS had different clinical features. Diagnosis of DRS in a typical case is not difficult. Careful and complete examination before surgery is important for appropriate treatments of DRS.