内転時に過剰に上・下偏位したDuane症候群2例の外科的治療

Surgically treated two cases of Duane syndrome with up or downshoot on adduction

要約　目的：内転時に上下の過剰偏位があるDuane症候群2手術例の報告。症例：2例とも女性で，年齢はそれぞれ6歳と42歳，いずれもDuane症候群Ⅲ型である。1例には右眼の内転時に上方偏位があり，下斜筋後転術で上方偏位が軽減した。他の1例には左眼の外斜視と内転時の下方偏位があり，左眼の外直筋と上斜筋を後転した。軽度の過矯正となり，下方偏位が残ったため，内直筋後転術を追加した。第1眼位で正位となり，内転時の下方偏位が軽減した。結論：Duane症候群Ⅲ型で上下偏位がある症例には，患眼の内・外直筋の後転術と斜筋の後転術が奏効することがある。

Abstract.　Purpose：To report the surgical outcome in two cases of Duane syndrome with up or downshoot on adduction. Cases and Findings：Two cases were females aged 6 and 42 years who were diagnosed as type Ⅲ Duane syndrome. One case showed upshoot during adduction of the right eye. Recession of inferior oblique resulted in reduction of upshoot. The other case showed exotropia in the primary position and downshoot during adduction of the left eye. Recession of lateral rectus and superior oblique muscles of the left eye resulted in overcorrection in the primary position with reduced downshoot. Additional recession of medial rectus muscle induced in orthotropia with reduced downshoot during adduction. Conclusion：Recession of ipsilateral medial and lateral rectus muscles and of oblique muscle may be effective for type Ⅲ Duane syndrome with up or downshoot on adduction.