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中华眼科医学杂志(电子版) ›› 2021, Vol. 11 ›› Issue (05) : 306 -310. doi: 10.3877/cma.j.issn.2095-2007.2021.05.010

综述

斜视转位手术之改良Nishida术式应用的研究进展
崔萌萌1, 李俊红2,†(), 冯张青2   
  1. 1. 030000　太原，山西医科大学第一临床医学院2018级硕士研究生
    2. 030002　太原，山西省眼科医院斜视与小儿眼科
  • 收稿日期:2021-01-16 出版日期:2021-10-28
  • 通信作者: 李俊红
  • 基金资助:
    山西省重点研发计划项目(201803D31185); 山西省眼科医院院内科研基金项目(C201802)

Advance on the application and progress of modified Nishida procedure for transposition of strabismus

Mengmeng Cui1, Junhong Li2,†(), Zhangqing Feng2   

  1. 1. Master′s degree 2018, First Clinical Medical College, Shanxi Medical University, Taiyuan 030000, China
    2. Strabismus and Pediatric Ophthalmology, Shanxi Province Eye Hospital, Taiyuan 030002, China
  • Received:2021-01-16 Published:2021-10-28
  • Corresponding author: Junhong Li
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崔萌萌, 李俊红, 冯张青. 斜视转位手术之改良Nishida术式应用的研究进展[J]. 中华眼科医学杂志(电子版), 2021, 11(05): 306-310.

Mengmeng Cui, Junhong Li, Zhangqing Feng. Advance on the application and progress of modified Nishida procedure for transposition of strabismus[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(05): 306-310.

麻痹性斜视常应用垂直肌转位术(VRT)矫正。术式包括Hummelsheim术式、Jensens术式、Foster术式及Nishida术式等，各种术式各有利弊。其中，改良后的Nishida术式因不切开肌肉而极大地减少了术后眼前节缺血的风险，对不同疾病导致的眼球运动障碍疗效显著。本文中笔者就该术式在眼球上转不足(先天性双上转肌麻痹)、眼球外转不足(外展神经麻痹和Duane综合征Ⅰ型)、眼球内转不足(先天性内直肌缺如和内窥镜鼻窦手术后的内直肌横断)、眼球下转不足(各种原因导致的下直肌麻痹和先天性下直肌发育不全)等治疗应用中的研究进展进行综述，旨在为临床中麻痹性斜视的治疗提供参考。

关键词: 垂直肌转位术, 改良Nishida术, 外直肌麻痹, Duane综合征Ⅰ型, 先天性内直肌缺如, 内直肌横断, 下直肌麻痹, 先天性下直肌发育不全

Vertical rectus muscle transposition (VRT) is usually used to correct patients with paralytic strabismus. There are many surgical methods, including Hummelsheim, Jensens, Foster, and Nishida. Each has its advantages and disadvantages. Among them, the modified Nishida procedure is of great benefit to reduce the risk of postoperative anterior segment ischemia because of non-cuting the muscles. Therefore, it is widely used in the treatment of eye movement disorders caused by various diseases. The insufficient upward rotation of the eye (congenital double superior transposition palsy), insufficient extraocular rotation (abducens nerve palsy, Duane syndrome type Ⅰ), insufficient intraocular rotation (congenital rectus absence, rectus transection after endoscopic sinus surgery), insufficient eyeball downturns (inferior rectus palsy caused by various reasons, and congenital inferior rectus dysplasia) were reviewed in this paper.

Key words: Vertical rectus muscle transposition, Modified Nishida, Abducens palsy, Duane syndrome type Ⅰ, Congenital medial rectus absence, Medial rectus transection, Inferior rectus paralysis, Inferior rectus muscle aplasia
图1 Nishida术式中左眼上直肌固定缝合的彩色照相　图A~D分别示上直肌(箭头所指)、附着点10 mm处1/3肌肉固定点(箭头所指)、缝合上直肌于固定点及将缝合的部分上直肌固定于颞上方距角巩膜缘后12 mm处(箭头所指)
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