间歇性和恒定性外斜视双眼视觉的临床研究  

Clinical research on binocular vision of intermittent and constant exotropia

作　　者：李珊珊[1] 赵蓉[1] 黄馨慧[1] 魏灿[1] 

机构地区：[1]上海市眼病防治中心,上海市200040

出　　处：《眼科新进展》2010年第12期1151-1153,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨间歇性外斜视和恒定性外斜视对双眼视功能的影响。方法选取18~25岁52例共同性外斜视患者,双眼矫正视力≥0.8,斜视角度为40△~60△（三棱镜遮盖去遮盖及交替遮盖法）、25°~30°（角膜映光法）,其中31例（男18例,女13例）为恒定性外斜视,21例（男10例,女11例）为存在间歇期的外斜视。均采用双眼外直肌后退术方式,术后恢复正位。术前及术后7d、术后6个月应用同视机检查患者远立体视觉和双眼远融合范围;应用颜少明立体视觉检查图检查近立体视觉。应用SAS系统广义线性数据分析模型分析两种斜视手术前后双眼视功能差异。结果术前近立体视和远融合范围间歇性外斜明显优于恒定性外斜,术后7d有明显改善（均为P〈0.05）;而远立体视2种斜视间差异不显著,术后7d改善不明显（均为P〉0.05）;术后6个月双眼视功能均明显优于术前和术后7d（均为P〈0.05）,间歇性和恒定性外斜视间差异也有统计学意义（P〈0.05）。结论间歇性和恒定性外斜视对双眼视功能影响有差异,而斜视矫正术是矫正双眼视觉的有效手段,应该选择恰当的时机进行,以提高患者斜视术后的视觉质量和生活质量。Objective To investigate the effect of intermittent and constant exotropia on binocular vision.Methods About 52 patients with concomitant exotropia,averaged from 18 years old to 25 years old,were enrolled in this study.Binocular corrected vision was be and more than 0.8,angle of strabismus was from 40△ to 60△ by triple prism covering,uncovering and alternative covering,and was from 25° to 30° by corneal fluorescence.There were 31 cases（18 male patients,13 female patients）with constant exotropia and 21 cases（10 male patients and 11 female patients）with intermittent exotropia.All patients were taken retropulsion of binocular lateral rectus and returned to normotopia after operation.Before operation,at 7 days and 6 months after operation,synoptophore was used to detect stereoscopic vision at distant place and binocular range of fusion at distant place,and stereoscopic examination by YAN Shao-Ming was used to detect stereoscopic vision at near place.SAS general linear data analyze model was used to investigate the difference of binocular visual function before and after operation of two strabotomies.Results Before operation,stereoscopic vision at near place and range of fusion at distant place of intermittent exotropia were obviously better than those of constant exotropia,and significantly improved at 7 days after operation（all P0.05）.There was no difference in stereoscopic vision at distant place between two kinds of exotropia,and without obvious improvement at 7 days after operation（all P0.05）.At postoperative 6 months,binocular vision was obviously better than those before operation and at 7 days after operation（both P0.05）,and difference was found between two kinds of exotropia（P0.05）.Conclusions There is difference in binocular vision between intermittent and constant exotropia.Squint correction is an effective way for correcting binocular vision.We should choose the correct time to take operation and improve the visual quality and quality of life after strabism operation.

关 键 词：外斜视 立体视觉 双眼视觉 

分 类 号：R777.4[医药卫生—眼科]