单纯压贴三棱镜矫正与压贴三棱镜联合手术治疗中等度数急性共同性内斜视的对比研究  

Comparative study of simple press-on prismatic correction and prismatic combined surgical treatment in moderate degree of acuteacquired comitant esotropia

作　　者：劳苇 刘芳[1] 黄金飞 LAO Wei;LIU Fang;HUANG Jin-fei(Department of Ophthalmology,Jiangmen Central Hospital,Jiangmen,Guangdong 529030)

机构地区：[1]广东省江门市中心医院眼科,广东江门529030

出　　处：《赣南医学院学报》2022年第9期928-931,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：广东省江门市科技计划项目(NO.2021YL01057)。

摘　　要：目的:对比单纯压贴三棱镜矫正与压贴三棱镜联合手术治疗对中等度数急性共同性内斜视(Acute acquired comitant esotropia,AACE)的疗效。方法:回顾性分析2018年6月至2021年3月在我科接受治疗的中等度数AACE患者18例,所有患者均行头部影像学检查排除颅脑疾病。10例行单纯压贴三棱镜矫正(单纯棱镜组),8例行压贴三棱镜联合手术治疗(联合手术组)。分别于治疗前、治疗后4个月、5个月、6个月测斜视度、Worth4点灯、近立体视功能。比较两种治疗方法治疗前与最后一次回访时患者斜视度的差异。评估两种治疗方法对Worth4点灯结果和近立体视功能影响的差异。结果:⑴两组患者在最后一次回访时斜视度都明显减少,与治疗前比较,差异有统计学意义(P<0.05)。⑵在最后一次回访时,17例患者恢复中心和周边融合功能,单纯压贴三棱镜矫正与压贴三棱镜联合手术治疗对Worth4点灯检查结果的影响差异无统计学意义(P>0.05)。⑶在最后一次回访时,12例患者恢复至中心立体视,两组对近立体的恢复差异无统计学意义(P>0.05)。结论:单纯压贴三棱镜矫正和压贴三棱镜联合手术治疗都可以减少中等度数急性共同性内斜视患者的斜视度,使其恢复双眼单视,单纯压贴三棱镜矫正对远融合功能和近立体视恢复的效果与压贴三棱镜联合手术治疗类似。Objective:To compare the efficacy of simple press-on prismatic correction versus prismatic combined surgical treatment in moderate degree of acuteacquired comitant esotropia(AACE).Methods:This retrospective study reviewed18 patients who receivedsimplepress-on prismatic correction or prismatic combined surgical treatmentexamined for moderate degree of AACE from June 2018 to March 2021 in Jiangmen central hospital.All of them had unremarkable neurological finding by imageological test.Ten patients receivedsimple press-on prismatic correction while the rest underwent prismatic combined surgical treatment.The outcome measures were deviations,Worth 4 dot and near stereoacuityat pre-treatment and post-treatment 4 months,5 months,6 months.The comparisonof deviations were noted before and after two treatmentsrespectively.The differences between simple press-on prismatic correction and prismatic combined surgical treatment were evaluated by Worth 4 dot and near stereoacuity.Results:⑴Thedeviations in two groups were decreased after treatment.There were significant differences betweenpre-treatment and 6-month follow-up(P<0.05).⑵Seventeenpatients recovered in foveal and peripheral fusion at the last Worth 4 dot examination,meanwhile no significant difference between simple press-on prismatic correctionand prismatic combined surgical treatmentin each follow-ups(P>0.05).⑶Twelvepatientsrecovered in foveal stereoacuity at the last random-dot stereogram,meanwhile no significant difference between two groupsin each visit(P>0.05).Conclusion:Bothsimple press-on prismatic correction and prismatic combined surgical treatment could decreasedeviations and regain horopter in moderate degree of AACE.The efficacy of simple press-on prismatic correction versus prismatic combined surgical treatment was similar in distant fusion and near stereoacuity.

关 键 词：内斜视 压贴三棱镜 手术治疗 斜视度 视功能 

分 类 号：R777.41[医药卫生—眼科]