甲状腺眼症による上下斜視に対する調節糸法と従来の後転法の比較

Comparison between conventional recession and adjustable suspension-recession procedure for vertical strabismus in Graves' ophthalmopathy

（G−7PM−3）　上下直筋の後転を施行した甲状腺眼症患者20例を対象に，調節糸法（7例）と従来の後転法（13例）をretrospectiveに治療効果を比較した。単位術量あたりの矯正効果には両群間に有意な差は認められず，正面視と読書眼位における両眼単一視野獲得の割合にも差がなかった。調節糸法を施行した2例に過矯正が認められた。そのうち1例には手術筋と拮抗筋に外眼筋の肥厚，他の1例は手術直後から軽度の過矯正があった。調節糸法では，手術筋，ならびにその拮抗筋の肥厚がある場合には低矯正にとどめるように注意することが過矯正を防止する上で重要である。

We reviewed the outcome of surgery in 20 cases of Graves' ophthalmopathy with vertical strabismus. Conventional recession of inferior or superior rectus muscle was performed in 13 cases and adjustable suspension-recession was performed in 7 cases. There was no significant difference between the two groups regarding the postoperative cor-rection of eye position per unit of muscle recession. Both groups showed similar rates of postoperative binocular single vision in the primary and reading positions. Overcorrection resulted in 2 cases after suspension-recession procedure. One of the 2 cases showed hypertrophy in the operated and the antagonist muscle. The other case showed mild overcor-rection immediately after surgery. Adjustable suture surgery for vertical strabismus with Graves' ophthalmopathy should therefore be undercorrected in the presence of hypertrophy in the operated or the antagonist muscle.