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  

Stereoacuity 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] 秦民安[1] 王晓春[1] 刘文织[1] 高爱华[1] 史颖君[1] 

机构地区：[1]枣庄市立医院眼科,山东枣庄277100

出　　处：《中国校医》2009年第3期254-256,共3页Chinese Journal of School Doctor

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17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,中间带方向比非中间带方向好,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 the stereoacuity before and after an operation of parks shift of neutral zone in congenital nystagrnus combined with paralytic strabismus. Methods By using stereograrns and near stereoacuity chart, preoperative measurement of distance and near stereoacuity in primary gaze tx^sition and neutral zone were qualitatively and quantitatively determined in 17 cases of congenital nystagmus combined with paralytic strabismus. After parks shift of neutral zone, stereoacuity measurement was evaluated by the similar method. The grade of stereoacuity before and after the operation was analyzed. Results Nystagmus was disappeared or obviously relieved in the primary gaze position, vision improved in 2 to 5 lines, and compensatory head posture was eliminated or improved after the operation in 17 cases, The stereoacuity gradually improved from 800 to 60 seconds of arc, peripheral to macular stereoacuity, and even foveal stereoaeuity. Conclusions 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 improve after the operation of parks shift of neutral zone.

关 键 词：眼球震颤 先天性 斜视 立体视锐度 

分 类 号：R777.46[医药卫生—眼科]