准分子激光原位角膜磨镶术对成人近视伴共同性外斜的疗效观察  

Effect of refractive surgery on ocular alignment in patients with myopia with intermittent exotropia

作　　者：刘怡[1] 赵宏伟[1] 李飞[1] 闫洪欣[1] 高萍[1] 刘彬彬[1] 白凤华[1] 

机构地区：[1]解放军306医院眼科,北京100101

出　　处：《总装备部医学学报》2011年第1期1-4,共4页Medical Journal of General Equipment Headquarters

摘　　要：目的评价准分子激光原位角膜磨镶术(Lasik)治疗成人近视伴共同性外斜的效果。方法对成人近视伴共同性外斜视56例施行Lasik手术,并对其手术前后视力、双眼单视功能、斜视度进行比较分析。结果术后3个月裸眼视力达到术前最佳矫正视力者占97.4%。双眼Ⅲ级视功能由术前7.1%提高到28.6%,手术前、后比较具有显著性差异(P<0.01)。间歇性外斜斜视度由术前(60.5±15.3)△降低到术后(35.3±10.6)△;恒定性外斜斜视度由术前(55.7±20.3)△降低到术后(40.5±15.7)△;手术前后比较均有显著性差异(P=0.024)。术后3个月,屈光参差组比非屈光参差组斜视度减少明显,分别为(30.2±15.1)Δ和(15.3±7.8)Δ,非屈光参差组眼位正位率15.3%,明显低于屈光参差组40.0%,两组比较具有显著性差异(χ2=4.79,P=0.03)。结论对于成人近视伴共同性外斜视者行Lasik手术能改善双眼单视功能,有效改善屈光参差,并减少斜视的斜视量,尤其对于术前有屈光参差者,其屈光状态的改善可直接影响斜视治疗效果。因此,成人近视伴外斜患者先行准分子激光手术,而后行斜视手术是较好的选择。Objective To evaluate the effect of refractive surgery on ocular alignment in patients with myopia with intermittent exotropia.Methods 56 adult patients with myopia with intermittent exotropia underwent refractive surgery.Vision acuity,ocular alignment and binocular function were measured before and after Lasik procedure.Results At 3 months the best corrected visual acuity was kept or improved as compared with that before operation in 97.4% of the patients.Improved ocular alignment and binocular function were also acheived.The postoperative deviation angles showed that net change of deviation was(30.2±15.1)Δ in anisometropia patients and(15.3±7.8)Δ in non-anisometropia patients.The recovery rate was 40.0% in anisometropia and 15.3% in non-anisometropia.Conclusion Lasik can improve the ability of binocular single vision,and it is effective in treating exotropia patients with anisometropia.It is better to have refractive surgery first in exotropia patients with myopia before squint surgery.

关 键 词：激光原位角膜磨镶术 屈光参差 外斜视 

分 类 号：R777.4[医药卫生—眼科]