间歇性外斜视手术时机及疗效的临床观察  

Clinical observation on the timing of operation and therapy for the intermittent exotropia

作　　者：韩二营 张清生 郭玉强 赵宪孟 李月礼 魏琳 丁磊 

机构地区：[1]濮阳市眼科医院,河南457000

出　　处：《中华眼外伤职业眼病杂志》2016年第9期683-687,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察间歇性外斜视手术前后双眼视功能并探讨手术时机。方法将97例间歇性外斜视按年龄分成4—8岁（54例）和9～18岁（43例）两组。观察两组手术前双眼视功能及术后双眼视功能恢复情况，并进行两组间比较分析。结果两组术后的双眼视功能均较术前明显改善，术后远、近立体视均较手术前明显提高，差异均有统计学意义（远立体视：4～8岁组z=-3．50，P=0．0005，9—18岁组0—2．02，P=0．04；近立体视：4～8岁组z=3．34，P=0．001，9～18岁组z=-2．16，P=0．03）。两组问术后正位率比较，差异无统计学意义（，=0．33，P=0．57）。术前具有融合点及融合范围者，术后双眼单视功能恢复率高，与术前不具有融合功能者比较，差异有统计学意义（X2=4．89，P=0．03）。结论间歇性外斜视应根据患者眼位、年龄、融合状态及双眼视功能多方面综合考虑手术时机，手术治疗有助于间歇性外斜视患者双眼视功能重建。Objective To observe the change of the function of binocular vision before and after surgery in intermittent exotropia, and analyze the timing of surgery. Methods A total of 97 intermittent exotropia patients were divided into two groups based on the age of surgery ： 4-8 years group, 54 cases and 9- 18 years group, 43 cases. The binocular vision restoration before and after surgery between the two groups were compared. Results The difference of the binocular vision function before and after surgery was statistically significant in the two groups. The 4-8 years group： z =-3. 50, P = 0. 0005; and 9-18 years group： z =-2. 02, P = 0.04. There was also significant difference in near stereoacuity before and after surgery of the two groups. The 4-8 years group： z -- -3.34, P =0. 001 ; and 9-18 years group： z =-2. 16, P = 0.03. There was no significant difference in the correction rate between the two groups （X2 = 0. 33, P = 0.57 ）. The rebuilding rate of binocular vision after surgery was significantly higher in patients with fusion function before surgery （X2 = 4. 89, P = 0. 03 ）. Conclusion Many factors need to be taken into consideration to choose the timing of surgery in intermittent exotropia, such as the position of eye, age, fusion range, binocular vision and so on. The surgery will substantially help to rebuild the binocular vision.

关 键 词：外斜视 间歇性 手术时机 双眼视功能 

分 类 号：R779.6[医药卫生—眼科]