三棱镜矫正小角度后天性上斜肌麻痹性斜视的处方量研究  

Study on the prescription amount of prism correction for small angle acquired superior oblique palsy patients

作　　者：赵世强 王乙迪 王兴存 孙阿莉 李添添 王小兵 ZHAO Shiqiang;WANG Yidi;WANG Xingcun(Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,北京市眼科学与视觉科学重点实验室,北京100730 [2]中国人民解放军中部战区空军医院眼科,大同037047

出　　处：《中国中医眼科杂志》2021年第10期717-720,729,共5页China Journal of Chinese Ophthalmology

摘　　要：目的探讨小角度后天性上斜肌麻痹引起复视的三棱镜矫正处方量及其相关性参数。方法回顾性收集2015年1月—2019年3月小角度后天性上斜肌麻痹引起复视并接受三棱镜矫正的患者19例,分别予以Von Graefe棱镜分离、马氏杆、同视机行斜视度检查;三棱镜矫正以达到复视消除、可耐受的最小三棱镜度数作为最终处方量。对不同方法斜视度测量数据进行统计分析,以及对垂直斜视度测量结果与处方量进行线性相关分析。结果(1)水平斜视度:Von Graefe棱镜分离(-0.74±1.99)^(△),马氏杆测量(-0.21±3.05)^(△),同视机测量(-0.73±4.03)^(△),三者比较差异无统计学意义(F=0.179,P=0.837);(2)垂直斜视度:Von Graefe棱镜分离(7.36±4.45)^(△),马氏杆测量(8.57±4.62)^(△),同视机测量(9.00±4.94)^(△),三者比较差异无统计学意义(F=0.623,P=0.540);(3)3种方法与处方量相关分析:棱镜处方量为(5.79±2.41)^(△)。与棱镜处方量的线性相关关系分别为,Von Graefe棱镜分离(r=0.648,P=0.003)、马氏杆检查(r=0.613,P=0.005)、同视机(r=0.502,P=0.028),均有统计学意义;与棱镜处方量的差异,Von Graefe棱镜分离(Z=-1.746,P=0.081),无统计学意义,而马氏杆(Z=-3.066,P=0.002),同视机(Z=-2.976,P=0.003),均有统计学意义。结论小角度后天性上斜肌麻痹患者以Von Graefe棱镜分离法测量的垂直斜视度可以作为三棱镜试戴的参考值,水平斜视度在处方中可以忽略。OBJECTIVE To investigate the prescription amount and related parameters of prism correction for small angle acquired superior oblique palsy patients.METHODS A retrospective case series of 19 patients with diplopia caused by small angle acquired superior oblique palsy in Beijing Tongren Hospital from January 2015 to March 2019 were conducted.All patients were corrected by prism and examined with Von Graefe prism separation,Maddox rod,and synoptophore.The final prescription of prism correction was the minimal amount of prism that could eliminate diplopia without discomfort.The strabismus measurement data of different methods were analyzed by single factor analysis of variance,and the linear correlation between the vertical strabismus measurement results and the prescription amount were analyzed.RESULTS(1)Horizontal:The degree of strabismus measured by Von Graefe prism separation in the horizontal direction was(-0.74±1.99)^(△),by Maddox rod was(-0.21±3.05)^(△),and by synoptophore was(-0.73±4.03)^(△).The differences were not statistically significant(F=0.179,P=0.837).(2)Vertical:The degree of strabismus measured by Von Graefe prism separation in the vertical direction was(7.36±4.45)^(△),by Maddox rod was(8.57±4.62)^(△),and by synoptophore was(9.00±4.94)^(△).The differences were not statistically significant(F=0.623,P=0.540).(3)Correlation analysis between three methods and prescription amount:The prism prescription amount was(5.79±2.41)^(△).The linear correlation between prism prescription amount and Von Graefe prism separation(r=0.648,P=0.003),Maddox rod(r=0.613,P=0.005),and synoptophore(r=0.502,P=0.028)were statistically significant.There was no significant difference between Von Graefe prism sepation and prism prescription amount(Z=-1.746,P=0.081),while Maddox rod(Z=-3.066,P=0.002)and synoptophore(Z=-2.976,P=0.003)were statistically significant.CONCLUSIONS For prism correction in patients with small angle acquired superior oblique palsy,the measurement result of Von Graefe prism separation in

关 键 词：上斜肌麻痹 复视 三棱镜 处方量 

分 类 号：R777.45[医药卫生—眼科]