共同性内、外斜视患者术前眼表状况及术后视觉功能的比较  

Comparison of preoperative ocular surface and postoperative visual function in patients with concomitant external and internal strabismus

作　　者：白莹 毛旖旎 曾春梅[1] BAI Ying;MAO Yini;ZENG Chunmei(Department of Ophthalmology,the Sixth People′s Hospital of Chengdu,Chengdu 610051,China)

机构地区：[1]成都市第六人民医院眼科,成都610051

出　　处：《新疆医科大学学报》2023年第6期772-776,共5页Journal of Xinjiang Medical University

基　　金：四川省卫生厅科研基金项目(1931392)。

摘　　要：目的 比较共同性内、外斜视患者的术前眼表状况及术后视觉功能恢复情况。方法 回顾性分析2018年2月至2020年5月成都市第六人民医院眼科诊治的80例共同性斜视患者的临床资料,其中,共同性外斜视患者46例(A组),共同性内斜视患者34例(B组)。对比两组患者术前泪河高度、刺激性泪河高度、眼红指数、第一次非侵袭性泪膜破裂时间(Break up time, BUT),平均BUT及术后融合范围、斜视角、立体视和双眼视觉功能分级情况。结果 A组的泪河高度、第一次BUT、平均BUT均高于B组,结膜眼红指数低于B组(P<0.05)。术后,A组的开散性融合范围高于B组,而辐辏性融合范围低于B组(P<0.05);A组近视33 cm、视远5 m的斜视角均高于B组(P<0.05);A组近视33 cm、视远5m的立体视均低于B组(P<0.05)。术前,两组视觉功能0~Ⅲ级占比差异无统计学意义(P>0.05);术后,A组视觉功能0级、Ⅰ级占比低于B组,而Ⅱ级、Ⅲ级占比高于B组(P<0.05)。Spearman相关性分析显示,泪河高度、刺激后泪河高度、第一次BUT、平均BUT与术后双眼视觉功能分级呈正相关;结膜眼红指数、睫状眼红指数与术后双眼视觉功能分级呈负相关。受试者工作特征(Receiver operating characteristic,ROC)曲线分析显示,泪河高度、刺激后泪河高度、第一次BUT、平均BUT、结膜眼红指数、睫状眼红指数预测共双眼视觉功能的曲线下面积(Area under curve,AUC)分别为0.776、0.749、0.737、0.761、0.754、0.855(P<0.05)。结论 与共同性内斜视患者相比,共同性外斜视患者的术前眼表泪液情况会对其术后视觉功能产生更大影响,术后共同性内、外斜视患者视觉功能分级比治疗前均有所改善,但共同性外斜视患者改善更为明显。Objective The ocular surface status and postoperative visual function recovery of the patients with concomitant external and internal strabismus were compared.Methods Retrospective analysis of the clinical data of 80 patients with concomitant strabismus diagnosed and treated in the ophthalmology department of the hospital from February 2018 to May 2020,including 46 patients with concomitant exotropia(Group A)and 34 patients with concomitant esotropia(Group B).The preoperative lacrimal river height,irritant lacrimal river height,eye red index,non-invasive tear film Break up time(BUT),mean BUT,postoperative fusion range,oblique Angle,stereoscopic vision and binocular vision function grading was compared between the two groups.Results The lacrimal river height,first BUT and average BUT of group A was higher than those of group B,and the conjunctival eye red index was lower than that of group B(P<0.05).After surgery,the convergence range of group A was higher than that of group B,while the convergence range of group B was lower(P<0.05).The oblique Angle of 33 cm myopia and 5 m myopia in group A was higher than that in group B(P<0.05).The stereovision of 33 cm myopia and 5 m vision in group A was lower than that in group B(P<0.05).Before the surgery,there was no significant difference in the proportion of grade 0,gradeⅠ,gradeⅡand gradeⅢbetween the two groups(P>0.05).After the operation,the proportion of grade 0 and gradeⅠin group A was lower than that in group B,while the proportion of gradeⅡand gradeⅢwas higher than that in group B(P<0.05).Spearman correlation analysis showed that lacrimal river height,lacrimal river height after stimulation,first BUT,average BUT was positively correlated with postoperative binocular visual function grade.The conjunctival eye red index and ciliary eye red index was negatively correlated with the grade of binocular visual function after the surgery.Receiver operating characteristic(ROC)curve analysis showed that,lacrimal river height,lacrimal river height after stimulation

关 键 词：共同性斜视 外斜视 内斜视 眼表 泪液 视觉功能 

分 类 号：R779.6[医药卫生—眼科]