改良Kestenbaum法治疗先天性眼球震颤合并麻痹性斜视手术前后的立体视觉分析  

Stereoacnity before and after operation of parks shift of neutral zone in congenital nystagmus combined with paralytic strabismus in modified Kestenbaum

作　　者：贾延磊[1] 王乐今[2] 布娟[1] 李静[1] 

机构地区：[1]山东省枣庄市立医院眼科,277100 [2]北京大学第三医院／北京大学眼科中心

出　　处：《中国临床实用医学》2009年第2期38-40,共3页China Clinical Practical Medicine

摘　　要：目的比较先天性眼球震颤合并麻痹性斜视行中间带移位术前后的立体视锐度的变化。方法采用同视机图片与Titmus立体视图本，对27例先天性眼球震颤合并麻痹性斜视，做手术前正前方与中间带方位的、远与近距离立体视定性和定量测定。实行中间带移位术后，再同样做远与近立体视锐度测定，进行分级对比分析。结果所有病例术后正前方基本不震颤或明显减轻，视力提高2～5行。代偿头位基本消除或改善。立体视从无到有，视锐度从800-至60-逐级提高由周边体视转变为黄斑体视、以至中心凹体视。结论先天性眼球震颤合并麻痹性斜视立体视觉术前可有部分发育，中间带方向好于非中间带方向，经中间带移位术后，不仅解决了眼球震颤、代偿头位、视力问题，而且能使远近立体视均得到不同程度的提高。Objective To evaluate thestereoacuity before and after operation of Parks shift of neutral zone in congenital nystagmus combined with paralytic strabismus. Methods Using stereograms and near stereoacuity chart,preoperative measurement of distance and near stereoacuity in primary gaze position and neutral zone were qualitatively and quantitatively determined in 27 congenital nystagmus combined with paralytic strabismus. After parks shift of neutral zone, streroacuity measurement was evaluated by the similar method. The grade of stereoacnity before and after operation was analyzed Rusuhs Nystagmus was disappeared or obviously relieved in the primary gaze position, vision was improved 2-5 lines, and compensatory head posture was eliminated or improved after operation in 27 cases. The stereoacuity was gradually improved from 800 to 60 seconds of arc, peripheral to macular stereoacuity, and even foveal stereoacuity. Conclusion Congenital nystagmus combined with paralytic strabismus may partly have stereoscopic vision. The stereoscopic vision in neutral zone may be better than in non-neutral zone. The nystagmus,compensatory head posture, and distance and near stereoscopic vision were improved after operation of Parks shift of neutral zone.

关 键 词：先天性眼球震颤 麻痹性斜视 立体视锐度 

分 类 号：R779.6[医药卫生—眼科]