Duane症候群Ⅰ型に対するKestenbaum手術

Effects of Kestenbaum surgical procedure on single binocular visual field in Duane retraction syndrome type 1

　Duane症候群のⅠ型を対象に，Kesten-baum手術と，従来の患眼にのみ手術を行う単眼手術の両眼単一視・視野にたいする手術効果の比較の考察を行い，4症例に施行したKestenbaum手術の治療結果を報告した。患眼の内転時に著しい眼球陥凹や，眼球の上下偏位がみられる場合は推奨されない手術法であるが，適度な術量であれば患眼の内転方向での眼球偏位の共同性を維持しつつ，外転方向への可動性を増加させ，両眼単一視・視野を増減することなく正面位へと移動することが可能な方法と思われる。

We operated on 4 cases of Duane retractionsyndrome type I after the procedure of Kesten-baum. We evaluated the field of single binocularvision before and after surgery. The findingsshowed that muscle transposition procedure onboth eyes according to Kestenbaum is not recom-mended when there is an increase of retractionaccompanied by limitation of adduction or a verti-cal up- or downshoot during adduction secondaryto cocontraction of horizontal rectus muscles. Withan adequate amount of surgery, Kestenbaum proce-dure could improve the motility during abductionwhile maintaining the concomitance in the field ofadduction.The field of single binocular visioncould thus be shifted to the primary position fromthe nasal field of position without loss in the fieldof postsurgical binocular vision.