Abstract：
OBJECTIVE: To evaluate the outcome of fenestration of the vertical rectus muscles in correcting vertical deviations.
METHODS: A retrospective chart review was conducted on patients who underwent fenestration surgery on the superior rectus (SR) or inferior rectus (IR) muscles. Ductions, versions, angle of deviations before and after surgery, and surgical details were analyzed. Success was defined as vertical alignment within 4 PD of orthophoria.
RESULTS: Nineteen patients were identified. The mean age of the patients was 19.3 ± 13.1 (range; 4 to 48) years. The mean follow-up was 6.5 ± 2.7 (range, 3 to 12) months. Eleven patients presented with dissociated vertical deviation (DVD), 2 patients with sensory hypertropia, and 6 patients with sensory hypotropia. Fourteen patients had concomitant horizontal muscle surgery. The mean change of the angle of deviation was 13 ± 3 (range, 8 to 20) PD after SR fenestration. and 12 ± 2 (range; 10 to 15) PD after IR fenestration. There was a significant improvement in the post operative angle of deviation in both groups (P value <0.001). Success was achieved in 10 (77%) of patients who underwent SR fenestration and in all patients underwent ir fenestration. Only one patient in the IR group developed a 1-mm lower lid retraction.
CONCLUSIONS: Fenestration of the vertical rectus muscles is an effective and safe method for correcting vertical deviations. We recommend increasing the amount of fenstration in DVD to further improve the outcome.
METHODS: A retrospective chart review was conducted on patients who underwent fenestration surgery on the superior rectus (SR) or inferior rectus (IR) muscles. Ductions, versions, angle of deviations before and after surgery, and surgical details were analyzed. Success was defined as vertical alignment within 4 PD of orthophoria.
RESULTS: Nineteen patients were identified. The mean age of the patients was 19.3 ± 13.1 (range; 4 to 48) years. The mean follow-up was 6.5 ± 2.7 (range, 3 to 12) months. Eleven patients presented with dissociated vertical deviation (DVD), 2 patients with sensory hypertropia, and 6 patients with sensory hypotropia. Fourteen patients had concomitant horizontal muscle surgery. The mean change of the angle of deviation was 13 ± 3 (range, 8 to 20) PD after SR fenestration. and 12 ± 2 (range; 10 to 15) PD after IR fenestration. There was a significant improvement in the post operative angle of deviation in both groups (P value <0.001). Success was achieved in 10 (77%) of patients who underwent SR fenestration and in all patients underwent ir fenestration. Only one patient in the IR group developed a 1-mm lower lid retraction.
CONCLUSIONS: Fenestration of the vertical rectus muscles is an effective and safe method for correcting vertical deviations. We recommend increasing the amount of fenstration in DVD to further improve the outcome.
摘要：
目的：评估垂直直肌开窗术纠正垂直偏差的效果。
方法：对接受上直肌（SR）或下直肌（IR）开窗手术的患者进行了回顾性图表回顾。管道,版本,手术前后的偏差角度，并分析了手术细节。成功被定义为在4个PD内的垂直对齐。
结果：确认了19例患者。患者的平均年龄为19.3±13.1（范围；4至48）岁。平均随访时间为6.5±2.7(范围，3至12）个月。11例患者出现分离的垂直偏差（DVD），2例感觉性前斜视,6例感觉性下斜视。14例患者同时进行了水平肌肉手术。偏差角度的平均变化为13±3（范围，8至20）SR开窗后的PD。IR开窗后PD为12±2（范围；10至15）。两组术后偏角均有显著改善(P值<0.001)。10例（77％）接受SR开窗术的患者和所有接受开窗术的患者均成功。IR组中只有一名患者出现了1毫米的下眼睑回缩。
结论：垂直直肌开窗术是纠正垂直偏差的有效且安全的方法。我们建议增加DVD开窗量，以进一步改善结果。
方法：对接受上直肌（SR）或下直肌（IR）开窗手术的患者进行了回顾性图表回顾。管道,版本,手术前后的偏差角度，并分析了手术细节。成功被定义为在4个PD内的垂直对齐。
结果：确认了19例患者。患者的平均年龄为19.3±13.1（范围；4至48）岁。平均随访时间为6.5±2.7(范围，3至12）个月。11例患者出现分离的垂直偏差（DVD），2例感觉性前斜视,6例感觉性下斜视。14例患者同时进行了水平肌肉手术。偏差角度的平均变化为13±3（范围，8至20）SR开窗后的PD。IR开窗后PD为12±2（范围；10至15）。两组术后偏角均有显著改善(P值<0.001)。10例（77％）接受SR开窗术的患者和所有接受开窗术的患者均成功。IR组中只有一名患者出现了1毫米的下眼睑回缩。
结论：垂直直肌开窗术是纠正垂直偏差的有效且安全的方法。我们建议增加DVD开窗量，以进一步改善结果。
