急性共同性内斜视患者的临床特点及手术治疗效果分析  

Analysis of clinical characteristics and surgical treatment effect of patients with acute acquired concomitant esotropia

作　　者：雷新平[1] 李瑶[2] 陈雪艺[2] 唐艳[1] LEI Xin-ping;LI Yao;CHEN Xue-yi;TANG Yan(Department of Ophthalmology,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA;Department of Ophthalmology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,CHINA)

机构地区：[1]宝鸡市人民医院眼科,陕西宝鸡721000 [2]新疆医科大学第一附属医院眼科,新疆乌鲁木齐830000

出　　处：《海南医学》2022年第24期3228-3231,共4页Hainan Medical Journal

基　　金：陕西省宝鸡市卫生和计划生育局科研课题(编号:2018-38)。

摘　　要：目的分析急性共同性内斜视(ACCE)患者临床特点及手术治疗效果。方法回顾性分析2020年4月至2021年12月在宝鸡市人民医院接受治疗的120例ACCE患者的临床资料,全部患者均通过对头部行影像学检查排除神经系统疾病。收集所有患者的年龄、病史、近距离用眼时间,并进行睫状肌麻痹验光、视网膜检影验光、三级视功能、斜视度、Titmus近立体视功能检查,分析其临床特点。待复视程度及斜视度稳定超过6个月后进行手术治疗,并观察疗效。采用Pearson相关性分析手术方案调整量与术眼内直肌同角膜缘间距的相关性。结果120例患者均无弱视治疗遮盖、家族遗传及眼部外伤史,神经内科及颅脑CT检查均为阴性;伴有轻度近视12例、中度近视60例、高度近视48例,平均等效球镜(-5.68±5.13)D;发病前,平均每天近距离(1/3 m)用眼时间为(9.26±1.61)h,平均持续时间(6.11±2.05)个月;平均近距离(1/3 m)斜视度(32.00±7.32)PD,远距离(6 m)斜视度平均(30.00±9.81)PD,差异无统计学意义(P>0.05);Titmus检查结果显示,无近立体视68例、80"~800"30例、不足60"22例;120例患者手术治疗后眼位均为正位,且复视消失;手术方案调整量与术眼内直肌同角膜缘间距的相关性分析显示,两者为正相关关系(r=0.724,P<0.01);所有患者随访6个月后都未复发,且视觉功能都有程度不同的恢复;术后Titmus检查结果显示,无近立体视13例、80"~800"患者60例、不足60"患者47例。结论本组ACCE患者长时间近距离用眼均超过6 h,且伴有中度近视,临床症状呈现为双眼复视,然而其眼球运动正常,远、近距离斜视度差异小,全矫手术为合理手术方案,可于术中联合术眼内直肌同角膜缘之间的距离对手术量进行调整。Objective To analyze the clinical characteristics and surgical treatment effect of patients with acute acquired concomitant esotropia(ACCE). Methods The clinical data of 120 patients with ACCE treated in Baoji People’s Hospital from April 2020 to December 2021 were retrospectively analyzed. All patients were excluded from neurological diseases by imaging examination of the head. The age, medical history, and near-eye use time of all patients were collected, and cycloplegic optometry, retinoscopy optometry, tertiary visual function, strabismus, and Titmus near-stereoscopic function were examined, and their clinical characteristics were analyzed. After the degree of diplopia and strabismus is stable for more than 6 months, surgical treatment was performed and the effect was observed. Pearson correlation was selected to analyze the correlation between the adjustment amount of the surgical plan and the distance between the inner rectus muscle and the limbus of the eye. Results A total of 120 patients had no amblyopia treatment coverage,family inheritance and ocular trauma history, and neurology and cranial CT examinations showed negative results. There were 12 cases with mild myopia, 60 cases with moderate myopia, and 48 cases with high myopia, with an average spherical equivalent of(-5.68±5.13) D. Before the onset of the disease, the average daily close-range(1/3 m) eye time was(9.26±1.61) h, and the average duration was(6.11±2.05) months. The average near-distance(1/3 m) strabismus was(32.00±7.32) PD, and the long-distance(6 m) strabismus was(30.00±9.81) PD in average, with no statistically significant difference(P>0.05). Titmus examination showed that 68 cases had no near stereopsis, 30 cases were 80 "~800", and22 cases were less than 60 ". Among the 120 patients, the eye position was upright and the diplopia disappeared after surgical treatment. The correlation analysis between the adjustment of the surgical plan and the distance between the intraocular rectus muscle and the corneal limbus showed that ther

关 键 词：急性共同性内斜视 临床特点 全矫手术 治疗体会 

分 类 号：R777.41[医药卫生—眼科]