先天性内斜视的临床表现和手术治疗  

Clinical features and surgical treatment of congenital esotropia

作　　者：邹云春[1] 刘陇黔[1] 彭海鹰[1] 李平惠[1] 

机构地区：[1]四川大学华西医院华西眼科中心,成都610041

出　　处：《中国实用眼科杂志》2006年第7期725-727,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的了解先天性内斜视的临床特征和手术治疗方法及疗效。方法回顾分析2000年10月至2003年12月我院斜视住院病人中132例先天性内斜视病例的临床资料及治疗结果。所有病例接受三棱镜、眼球运动检查,大龄合作患儿同时行同视机、线状镜等检查。手术方法以对称性双眼内直肌后退为主,斜视度较大者同时行一眼外直肌缩短,如果有垂直斜视先行垂直肌肉手术矫正。术后随访时间6～48个月,平均24个月。结果先天性内斜视多数患者就诊年龄在1岁以后,弱视发生率较小,内斜视度较大,多在40△～60△之间,眼外肌功能多表现为双眼运动时内直肌功能过强。本组资料中113例患者手术后达到临床治愈,一次手术临床治愈率86.3%。结论先天性内斜视多为双眼交替性,斜视度较大,需要手术治疗,一旦明确诊断,应尽早手术,可获得满意效果。Objective To investigate the clinical characteristics and the methods and effect of surgical treatment of congenital esotropia. Methods The clinical data and the results of the treatment of 132 inpatients with congenital esotropia in our department from Oct 2000 to Dec 2003 were retrospectively analyzed. All of the patients underwent the examination with three-prism and eye movement test and the examinations with synoptophore and streak retinoscoope were performed on the elder children additionally. The surgical procedures mainly included symmetrical recession of binocular medial recti, and combined shortening of monocular lateral rectus in patient with high degree of strabismus. Vertical muscle operation would be performed firstly on the patient with vertical strabismus. The follow-up period lasted for 6 to 48 months, with the mean of 24 months. Results Most of the patients with congenital esotropia when they went to the hospital was more than 1 year old, whose incidence of amblyopia was low while the deviated degrees were high （40^△-60^△）. The overaction of medial-recti function was commonly seen in these cases. In 132 patients, 113 recovered after the surgery with the one-off curative ratio of 86.3%. Conclusions Most of the patients with congenital esotropia was binocular alternation with high deviated degrees. Surgical treatment should be performed early once the diagnosis is confn＇med in order to get the satisfying results.

关 键 词：内斜视 先天性 临床特点 手术 

分 类 号：R777.41[医药卫生—眼科] R681.6[医药卫生—临床医学]