间歇性外斜视按三棱镜耐受后斜视度设计手术的临床观察  

Clinical study on the efticacy of the intermittent exouopia surgery with prior-surgery prism adaptation test

作　　者：金涵[1] 李岚[1] 田军[1] 徐洁[1] 舒秀梅[1] 周水莲[1] 

机构地区：[1]江西省人民医院眼科中心,南昌330006

出　　处：《中国实用眼科杂志》2016年第8期832-835,共4页Chinese Journal of Practical Ophthalmology

基　　金：江西省科技厅社会发展计划（20132BBQ70094）

摘　　要：目的观察间歇性外斜视按三棱镜加交替遮盖斜视度测定量与三棱镜耐受试验（PAT）后斜视度测定量设计手术的疗效，并进行比较研究。方法临床病例回顾性系列研究。对2013年6月至2014年3月在江西省人民医院眼科中心住院的间歇性外斜视患者50例，男性22例，女性28例；年龄5～22岁。应用三棱镜加交替遮盖法及三棱镜耐受试验（PAT）后6m与33cm两种方法进行斜视度测量。并行常规、屈光及双眼视觉检查。随机分成两组，每组25例。对照组按三棱镜加交替遮盖测量的远近斜视度最大量设计手术，观察组按三棱镜耐受（PAT）后测量的远近斜视度最大量设计手术。术后第1d、6月、1年检查眼位、双眼视觉并进行统计分析。结果术后第1d对照组正位14例、过矫3例、欠矫8例；观察组正位13例、过矫10例、欠矫2例；两组比较秩和检验（Z=2．111，P=0．035）差异有统计学意义。术后6月，对照组正位16例、过矫1例、欠矫8例；观察组正位19例、过矫4例、欠矫2例，两组病例6月后过矫者逐渐正位，两者比较秩和检验（Z=1．265，P=0．206）无统计学意义。术后1年，对照组正位14例、过矫0例、欠11例；观察组正位21例、过矫1例、欠矫3例；两者比较秩和检验（Z=1．265，P=0．206）无统计学意义，但可见对照组有明显回退。两组术后获得Ⅱ级视功能数比较差异有统计学意义（Fisher单侧检验P〈O．05）；两组术后近立体视患者增加差异有统计学意义（Fisher单侧检验P〈0．05）。结论三棱镜耐受试验（PAT）可以测出间歇性外斜视患者最大的视远及视近斜视度数，按三棱镜耐受试验（PAT）后测得斜视度设计手术，可降低欠矫率，减少回退，更好的建立双眼视觉功能，提高手术疗效。但也要注意短期过矫现象。Objective To study and compare the efficacy of the surgical treatment of intermittent exouopia designed based on the measured angles from routine examination for strabismus and prism adaptation Test. Methods Total of 50 intermittent exouopia in-patients, 22 males and 28 females, age from 5 to 22 were collected in Eye Center of Jiangxi Province People＇s Hospital, from June 2013 to March 2014. The prism and alternative cover test were used to examine the angle of strabismus of the patients using two methods, original 6m ＆ 33cm, and PAT 6m ＆ 33cm. The routine examination, refractive examination, and vision examinations on both eyes were also carried out. The patients were randomly separated into two groups for each had 25 patients. The comparison groups were carried out the intermittent exouopia surgery based on the examined angles from the original 6m ＆ 33cm method, while the observation group was carried out the surgery based on the examined angles from the PAT 6m ＆ 33cm method. The eye position and vision test for both eyes were collected and analyzed post-surgery of 1 day, 6 months, and 1 year. Results In the post-surgery 1 day, there were 14 patients with alignment, 3 with overcorrection, and 8 with undercorrection in the comparison group; there were 13 patients with alignment, 10 with overcorrection, and 2 with undercorrection in the comparison group; comparing the two signed-rank tests （Z =2.111, P =0.035） was of statistical significance. Post-surgery 6 months, there were 16 patients with alignment, 1 with overcorrection, and 8 with undercorrection in the comparison group; there were 19 patients with alignment, 4 with overcorrection, and 2 with undercorrection in the comparison group; comparing the son group; there were 21 patients with alignment, 1 with undercorrection, and 3 with undercorrection in the comparison group; comparing the two signed-rank tests （Z =1.265, P =0.206） was of no statistical significance. The difference of gaining II binocular vision in both groups was of statistical

关 键 词：间歇性外斜视 三棱镜耐受试验(PAT) 三棱镜加交替遮盖法 手术 疗效 

分 类 号：R777.41[医药卫生—眼科]