间歇性外斜视手术前后交叉视差和非交叉视差立体视觉的临床研究  

Clinical study on crossed disparity and uncrossed disparity in intermittent exotropia before and after surgery

作　　者：林楠[1] 卢炜[1] 王京辉[1] 

机构地区：[1]首都医科大学北京同仁眼科中心,100730

出　　处：《中华眼科杂志》2006年第2期139-144,共6页Chinese Journal of Ophthalmology

摘　　要：目的探讨间歇性外斜视患者手术前后近零视差、交叉视差及非交叉视差的临床变化规律。方法将100例间歇性外斜视患者分为4组,使用立体视觉检查图检测手术前后的近零视差、交叉视差及非交叉视差,使用同视机测定远融合范围和远立体视,分析、比较检查结果。结果在全部患者中,手术前后均无近零视差仅与非交叉视差共存者和交叉视差仅与非交叉视差共存者,也无交叉视差、非交叉视差独立存在者。4组患者术后近零视差、交叉视差、非交叉视差、远融合范围及远立体视均较术前明显改善,差异有统计学意义(P<0.01)。手术前后远融合范围4组患者比较,差异均无统计学意义(P>0.05)。术后远立体视4组患者比较,差异有统计学意义(P<0.01),1组和2组患者远立体视的重建均优于3组和4组。结论(1)间歇性外斜视患者近零视差立体视锐度、交叉视差和非交叉视差立体感知度不健全,损伤次序依次为非交叉视差、交叉视差、近零视差,重建顺序与之相反。(2)非交叉视差立体感知度严重受损或消失,也应视为间歇性外斜视的手术指征,此时应立即进行手术治疗,以利双眼视功能的重建。Objective To understand the clinical variety of zero disparity, crossed disparity and uncrossed disparity in intermittent exotropia before and after strabismus surgery. Methods 100 cases of intermittent exotropia were involved in the study. Before and after surgery, zero disparity stereo-acuity, crossed disparity and uncrossed disparity stereo-acuity were examined with stereogram designed by Yan Shaoming, distance fusion range and distance stereo-acuity were examined with traditional and random dot synoptophore stereogram. The patients were divided into four groups based on the results of the stereogram examination before surgery. Results In the 100 cases, there was no coexistence of zero disparity and uncrossed disparity, no coexistence of crossed and uncrossed disparity, and no existence of only crossed disparity or only uncrossed disparity. Postoperative zero disparity, crossed disparity, uncrossed disparity, distance fusion range and distance stereo-acuity improved significantly compared with the preoperative results for each group （P 〈 0.01 ）. The comparison of distance fusion range was not prominent before and after strabismus surgery in the 4 groups （ P 〉 0.05）. The distribution of distance stereo-acuity was prominent after strabismus surgery in the 4 groups （ P 〈 0.01 ）. Distance stereo-acuity rebuilding after surgery in group 1 and group 2 was better than that in group 3 and group 4. Conclusions （ 1 ） In the cases with intermittent exotropia, zero disparity stereo-acuity, crossed disparity and uncrossed disparity stereo-acuity are abnormal. The sequential damage of stereopsis is uncrossed disparity, crossed disparity and zero disparity. The sequential rebuilding of stereopsis is zero disparity, crossed disparity and uncrossed disparity. （2） The serious damage or disappearance of uncrossed disparity stereo-acuity is the indication of intermittent exotropia surgery for perfect binocular vision rebuilding.

关 键 词：外斜视 视觉差异 视觉 双眼 深度知觉 

分 类 号：R779.6[医药卫生—眼科]