间歇性外斜视儿童术后视感知觉训练对各级视功能恢复的临床观察  

Clinical observation of postoperative visual perceptual training in children with intermittent exotropia on the recovery of visual function at all levels

作　　者：丁艳丽 董彦平 刘勤 王玉瑾[2] 王福利 Yan-Li Ding;Yan-Ping Dong;Qin Liu;Yu-Jin Wang;Fu-Li Wang(The First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,Gansu Province,China;Department of Ophthalmology,the First People's Hospital of Lanzhou City,Lanzhou 730050,Gansu Province,China;Department of Ophthalmology,Gansu Provincial Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃省兰州市730000 [2]中国甘肃省兰州市第一人民医院眼科,730050 [3]甘肃省人民医院眼科,甘肃省兰州市730000

出　　处：《国际眼科杂志》2023年第5期754-758,共5页International Eye Science

基　　金：兰州市人才创新创业项目(No.2020-RC-70)。

摘　　要：目的:探讨视感知觉训练在间歇性外斜视(IXT)儿童患者术后各级视功能恢复以及知觉眼位改善中的作用。方法:前瞻性临床研究。收集2022-01/06就诊于兰州市第一人民医院眼科行斜视矫正手术且完成术后3mo随访的IXT患者74例。术后1d随机将患者分为2组:训练组35例患者进行双眼视感知觉训练,对照组39例患者不进行任何训练。观察两组患者术后1d, 3mo各级视功能和知觉眼位变化情况。结果:术后1d训练组有同时视者24例(69%),术后3mo同时视功能恢复患者为34例(97%),显著高于术后1d(P=0.002);术后3mo对照组有融合功能者22例(56%)、远立体视者13例(33%)、动态立体视者20例(51%)、静态精细立体视者17例(44%),训练组有融合功能者31例(89%)、远立体视者25例(71%)、动态立体视者30例(86%)、静态精细立体视者27例(77%),均显著高于对照组(均P<0.05);训练组患者知觉眼位偏移程度较对照组下降更明显(均P<0.05)。结论:IXT儿童患者术后进行视感知觉训练可以促进各级视功能恢复,并改善知觉眼位,提高大脑知觉水平对眼位的控制能力。AIM:To investigate the role of visual perception training on the recovery of visual function at all levels and the improvement of perceptual eye position in children with intermittent exotropia(IXT).METHODS:Prospective clinical study.A total of 74 patients with IXT who received corrective surgery for strabismus in the Ophthalmology Department of the First People’s Hospital of Lanzhou City from January to June 2022 were collected and followed up for 3mo.The patients were randomly divided into 2 groups at 1d after surgery:35 patients in the training group received binocular visual perception training,and 39 patients in the control group did not receive visual training.The changes of visual function and perceived eye position at all levels were observed at 1d and 3mo after operation.RESULTS:There were 24 patients(69%)with simultaneous perception in the training group at 1d after surgery and 34 patients(97%)with recovered visual function at 3mo after surgery,which was significantly higher than 1d after surgery(P=0.002).Furthermore,there were 22 cases(56%)of fusion function in the control group at 3mo after surgery,13 cases(33%)of far stereopsis,20 cases(51%)of dynamic stereopsis and 17 cases(44%)of static fine stereopsis.In the training group,there were 31 cases(89%)of fusion function,25 cases(71%)of far stereopsis,30 cases(86%)of dynamic stereopsis and 27 cases(77%)of static fine stereopsis,which were significantly higher than those in the control group(all P<0.05).The degree of perceived eye displacement in the training group decreased more significantly than that in the control group(all P<0.05).CONCLUSION:Postoperative visual perceptual training in children with IXT can promote recovery of visual function at all levels,improve perceptual eye position and enhance the control of eye position at the perceptual level of the brain.

关 键 词：间歇性外斜视 视感知觉训练 双眼视觉功能 知觉眼位 

分 类 号：R779.6[医药卫生—眼科]