内斜视V征的手术治疗和临床观察  

Operation treatment and clinical observation of “V” pattern esotropia

作　　者：殷小龙[1] 邓燕[1] 杨洋[1] 于春红[1] 廖瑜俊[1] 彭小维[1] 

机构地区：[1]南昌大学第二附属医院儿童眼科,江西省南昌市330006

出　　处：《眼科新进展》2012年第9期853-854,858,共3页Recent Advances in Ophthalmology

基　　金：江西省卫生厅重大科技计划(编号:20045032)~~

摘　　要：目的探讨内斜视V征的临床特点和手术疗效。方法总结我院2007年至2010年38例(76眼)住院手术的内斜视V征患者资料,其中合并下斜肌功能亢进者31例行下斜肌减弱术和常规水平直肌后退和(或)缩短术;不合并下斜肌功能亢进者7例分别行双眼内直肌后徙术和(或)联合肌止端向闭口端移位术、外直肌缩短术并肌止端向上移位术。检查分析患者手术前后斜视度数、双眼视功能及手术效果。结果术前上、下注视眼位的垂直斜视角之差为15△～40△,平均22.7△,其中15△～20△者21例(55.26%),21△～30△者14例(36.84%),≥31△者3例(7.89%);术后上、下注视眼位的垂直斜视角之差为5△～20△,平均6.8△,其中5△～14△者34例(89.47%),15△～20△者4例(10.53%);术前、术后垂直斜视角差异有统计学意义(t=16.907,P<0.05)。术前水平斜视角平均18.4△,术后为4.6△,差异有统计学意义(t=24.624,P<0.05)。术前、术后同视功能差异有统计学意义(χ2=16.110,P<0.05)。术后眼位正位、V征消失者29例(76.32%),V征缓解者5例(13.16%),V征仍然存在者4例(10.53%)。结论内斜视V征发病年龄早,多合并下斜肌功能亢进,减弱下斜肌功能可有效矫治内斜视V征。不合并下斜肌功能亢进者,行内直肌后徙联合肌止端向闭口端移位术,也可有效缓解内斜视V征。Objective To investigate the operation treatment and clinical features of ＂V＂ pattern esotropia. Methods Thirty-eight patients （76 eyes） with ＂V＂ pattern esotropia in our hospital from 2007 to 2010 were retrospectively studied,in which 31 cases with inferior oblique overaction were treated with inferior oblique weakening procedure and horizontal rectus recession or /and resection procedure,and 7 cases without inferior oblique overaction were treated with dual medial rectus recession or/and joint muscle ends transposition,lateral rectus shortening procedure and muscle ends upper transposition.The preoperative and postoperative strabismus diopter,therapeutic effects and binocular visual function were examined and analyzed. Results The preoperative difference of vertical squint angle between upgaze and downgaze was from 15^△ to 40^△（averaged 22.7^△）,in which 21 cases（55.26%） were from 15^△ to 20^△,14 cases（36.84%） were from 21^△ to 30^△,3 cases（7.89%） were more than 31^△;The postoperative difference of vertical squint angle between up-gaze and down-gaze was from 5^△ to 20^△（averaged 6.8^△）,in which 34 cases（89.47%） were from 5^△ to 14^△,4 cases（10.53%） were from 15^△ to 20^△;there was statistical difference（t=16.907,P〈0.05）.The mean preoperative and postoperative horizontal squint angle were 18.4^△ and 4.6^△,respectively,there was statistical difference（t=24.624,P〈0.05）.There was statistical difference in binocular visual function before and after operation（χ2=16.110,P〈0.05）.A total of 29 cases（76.32%） acquired alignment of the eyes without ＂V＂ pattern after operation,5 cases（13.16%） were alleviated,4 cases （10.53%） still had ＂V＂ pattern. Conclusion The ＂V＂ pattern esotropia appears in many young patients with inferior oblique overaction mostly,can be treated with inferior oblique weakening procedure effectively.And vertical transposition of medial rectus muscle can relieve the ＂V＂ pattern e

关 键 词：内斜视V征 下斜肌功能亢进 双眼视功能 

分 类 号：R777.41[医药卫生—眼科]