Seven. Eye doctor advice: when can choose super constant after surgery?Beijing Children's Hospital, director of Ophthalmology experience:1,
Seven. Eye doctor advice: when can choose super constant after surgery?
Beijing Children's Hospital, director of Ophthalmology experience:
1, the medial rectus Von Noorden report on congenital esotropia, medial rectus muscle after the act of 8 mm, can reduce the number of operations, a surgical success rate of over 70%. Lack of practice in china. Our experience is that preoperative motor function of children examination of monocular medial rectus, medial rectus muscle is too strong and more than strong cases can be bilateral medial rectus supernormal after antedisplacement operation, through a large number of surgical cases demonstrated bilateral medial rectus muscle surgery can correct equivalence super constant esotropia in 40 or more, for surgery before the diagnosis of medial rectus muscle function is too strong in cases after surgery did not appear to exercise limitation of the medial rectus.
2 external rectus muscle paralysis, to be Jesen rectus joint surgery or upper and lower rectus muscle transposition of the patients in the medial rectus muscle after the act of 6 mm, in order to ensure the realization of the effect of the operation. When the medial rectus muscle is more than 6 mm, it not only causes the obvious limitation of internal rotation, but also appears to be considered before surgery,
2, inferior rectus: due to the anatomy of the inferior rectus is closely related to the lower eyelid, even if fully separated, it is inevitable that the impact on the eyelid position after surgery. Operation control within 5 mm of the eyelid position effect is acceptable: under normal circumstances the muscle acts of not more than 5 mm, our experience is that after the surgery of the inferior rectus recession must be conservative, otherwise &ldquo lower eyelid surgery; degenerate ” will bring trouble to the children's appearance.
3, upper rectus: DVD patients, after the starting point should be 7 mm, or even up to 12 ~ 14 mm. But for the general vertical strabismus, superior rectus should not be selected after the constant. Otherwise, when the eyes work together, the direction of the upper rectus muscle will occur after the fall.
4, the lateral rectus muscle: the extra rectus muscle is the largest after nearly ten years of fried the hottest “ new technology ”. Its positive aspects are:
(1) the lateral rectus muscle after conventional acts from 5 mm to 7 mm, reducing the amount of resection of medial rectus strabismus, increase the one-time success rate, postoperative appearance or.
(2) the effect of super constant on the ≤ 40Δ intermittent exotropia, especially those who were too strong, had a satisfactory effect. After the general amount of not more than 9 mm.
(3) of monocular vision, external oblique angle of the patient requires surgery completed only in the affected eye, lateral rectus supernormal after internal rectus and can receive good results.
(4) of rectus oculomotor nerve palsy after only 12 to 14 mm, which is the most difficult to be corrected exotropia.
The amount of lateral rectus recession will cause long limited eye movement after surgery, and look at the far undercorrection, near the overcorrection to overcome diplopia and visual confusion and other adverse consequences, currently has rarely used this technology.