Analyse der Dosis-Wirkungsbeziehung einfacher und kombinierter Obliquusoperationen zur Behandlung des einseitigen Strabismus sursoadductorius

摘要

Aim of this retrospective study was to analyse the dose-response relationship of verticaldeviation and excyclodeviation and the length of inferior oblique muscle recession and combined superior oblique muscle tucking at patients with unilateral Strabismus sursoadductorius. Contrary to the three step graduation of other studies in this study the length of the recession or tucking of the muscles were adopted individually to the preoperative Verticaldeviation. In inferior oblique muscle recession a linear dose-response relationship could be established. The effect was at 0,65°/ mm. There was no dose-response relationship for the excyclodeviation. The effect was at 0,47° / mm. For the combined obliques muscles surgery there was no dose-response relationship neither for verticaldevition nor excyclodeviation. The effect of the verticaldeviation was at 0.84° and for the excyclodeviation at 0,44°/ mm. The reason for the nonexisting dose-response relationship of verticaldeviation at the combined oblique muscle surgery might be the selfregulating effect of high preoperative verticaldevitions. The nonexisting dose-response relationship for the Cyclodeviation might be caused by decrease of the torsional effect over time postoperatively. The binocular vision and the head tilt improved at most patients. But there was no relation between the amount of the reduction of the squint and the results. The excellent success rate with a postoperative verticaldeviation smaller than 5° at 74% at the maximum of the force of the inferior oblique muscle proves the efficacy of the operation methods. So the inferior oblique muscle recession and the combined oblique muscle surgery are save and effective operation methods for therapy of Strabismus sursoadductorius.