共同性水平斜视手术前后单眼注视野的临床研究  

Clinical study and discussion of the monocular fixation field before and after concomitant horizontal strabismus surgery

作　　者：张晓蕾[1] 吴夕[1] 牛兰俊[1] 

机构地区：[1]北京大学人民医院眼科,北京100044

出　　处：《眼视光学杂志》2008年第5期359-364,共6页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的比较正常人及共同性水平斜视手术患者的单眼注视野手术前后的变化,了解矫正术后眼球运动及对称性是否变化及其特点,探讨斜视手术方式及手术量之间的关系,为术后优化眼球运动提供依据。方法两组对比实验,每组各20例,最佳矫正视力均≥4.8。A组为正常对照组,平均年龄为24（15～45）岁,无显性斜视,各方向眼球运动正常。B组为共同性水平斜视手术患者组,平均年龄为19（10～42）岁。采用弓形视野计及Humphrey视野分析仪进行各组单眼注视野检查,其中B组分别于术前、术后6周内、6周后重复检查。用SPSS11.5统计学软件进行数据分析。结果①单眼注视野：A组和B组（术前）均为向外下方注视范围最大,且两组各方向单眼注视野经t检验,差异无统计学意义（P〉0.05）。②手术方式与单眼注视野的改变：B组中,行常规量单条水平直肌减弱术7眼,直肌减弱联合加强术16眼,分别分析两种术式术前与术后6周内、6周后的单眼注视野,经t检验,手术前后相应直肌力量方向上单眼注视野差异无统计学意义（P〉0.05）。手术后不同时期注视野的变化：直肌减弱联合加强术组,弓形视野计结果显示：与术前比较,术后6周内,16眼中有4眼斜视方向上注视野缩小明显;Humphrey视野分析仪结果显示：与术前比较,术后6周内,16眼中有2眼斜视方向上注视野缩小明显,经配对t检验,较术前差异有统计学意义（P〈0.05）。随访至术后6周,经配对t检验,差异无统计学意义（P〉0.05）。③斜视手术量与单眼注视野的变化分析：B组施行常规手术量的单眼注视野：应用t检验,在整体上术前与术后变化差异无统计学意义（P〉0.05）。超常量手术的单眼注视野：超常量手术2例,术后术眼外转方向上注视野减小,眼球外展有一定程度受限。结论斜视手术前后测定单眼注视野的变化,能客观定量反映眼外肌�Objective To study eye movement and change in binocular balance and the characteristics of this change after strabismus surgery; to discuss the relationship between the patterns of strabismus surgery and the amount of muscle involved in the operation. This study included the fixation fields of both normal persons and patients with horizontal strabismus and research on the fixation field before and after strabismus surgery. To identify factors that may improve ocular motility after surgery. Methods Two groups of 20 subjects each with a standard BCVA of ≥4.8 were included in the study. Group A was the control group, with an average age of 24（15～45） years, no heterotropia and normal ocular motility. Group B was the experimental group , with an average age of 19（10～42） years, with horizontal herterotropia. The monocular fixation field was examined in each group using an arc campimeter and Humphrey campimeter. The subjects in group B were examined 6 weeks preoperatively and 6 weeks postoperatively. SPSS 11.5 software was used for statistical analysis. Results ①Monocular field fixation： The area of the monocular field fixation was widest in the lateral-inferior area in both groups. There was no distinct difference in preoperative monocular fixation field between groups A and B. ②The relationship between the pattern used in the operation and alteration of the monocular fixation field： For concomitant horizontal strabismus patients, there was a routine recession of a single rectus in 7 eyes, recession with antagonist muscle resection in 16 eyes, and no prominent difference was found in their monocular fixation fields before and after the operation. In the group that had recession with antagonist muscle resection, in the 6 weeks after the operation, 4 of 16 eyes showed a reduction in the fixation field using an arc campimeter. This outcome was confirmed with a Humphrey campimeter. The reduction of the fixation field in 4 eyes showed a prominent difference, but no prominent difference was found after

关 键 词：共同性水平斜视 外科手术 单眼注视野 眼球运动 

分 类 号：R779.6[医药卫生—眼科]