不同屈光状态急性共同性内斜视患者的临床特征及治疗体会  

Clinical characteristics and treatment of patients with acute acquired concomitant esotropia in different refractive status

作　　者：张桂鸥 郭长梅 张璐 李娜敏 周健 张自峰 Gui-Ou Zhang;Chang-Mei Guo;Lu Zhang;Na-Min Li;Jian Zhou;Zi-Feng Zhang(Department of Ophthalmology,Xijing Hospital,Air Force Medical University,Eye Institute of PLA,Xi an 710032,Shaanxi Province,China)

机构地区：[1]空军军医大学西京医院眼科、全军眼科研究所,中国陕西省西安市710032

出　　处：《国际眼科杂志》2023年第8期1357-1361,共5页International Eye Science

基　　金：西京医院学科助推计划多学科综合诊疗项目(No.XJZT19MDT12);空军军医大学临床研究项目(No.2022LC2247)。

摘　　要：目的:分析不同屈光状态急性共同性内斜视患者的临床特征及治疗情况。方法:回顾分析2020-01/2022-01我院收治的非Ⅰ型急性共同性内斜视患者110例,根据治疗前屈光状态分为非近视组(30例,等效球镜>-0.5D)和近视组(80例,等效球镜≤-0.5D),分析两组患者治疗前斜视度、AC/A值、视功能情况及手术方式和术后复发情况等。结果:非近视组患者裸眼视近斜视度[(47.13±23.54)^(△)]与视远斜视度[(48.90±22.59)^(△)]无差异(P>0.05);近视组患者裸眼视近斜视度[(40.49±26.09)^(△)]小于视远斜视度[(50.09±25.41)^(△)](P<0.001);两组患者相同距离斜视度无差异(P>0.05)。非近视组患者AC/A值(5.40±2.23)大于近视组(3.14±3.10)(P<0.05)。近视组患者近立体视优于非近视组(P<0.05)。非近视组手术方式多样,近视组多采用外直肌缩短和/或内直肌后退术。结论:不同屈光状态均可发生急性共同性内斜视,非近视者远、近斜视度无明显差异,AC/A值高,手术方式多样;近视者视近斜视度小于视远斜视度,AC/A值正常,近立体视更佳,多采用外直肌缩短和/或内直肌后退术。AIM:To analyze the clinical characteristics and treatment of patients with acute acquired concomitant esotropia(AACE)in different refractive status.METHODS:A retrospective analysis was conducted on 110 patients with non-type I AACE treated from January 2020 to January 2022.The non-myopic group(30 cases,spherical equivalent>-0.5D)and the myopic group(80 cases,spherical equivalent≤-0.5D)were divided according to the refractive status.The degree of deviation,accommodative convergence and accommodation ratio(AC/A),visual function,and surgical methods were observed.RESULTS:The non-myopic group had no difference in the degree of near deviation[(47.13±23.54)^(△)]and the degree of distant deviation[(48.90±22.59)^(△)](P>0.05),near deviation[(40.49±26.09)^(△)]of myopic group was less than distant deviation[(50.09±25.41)^(△)](P<0.001),and there was no difference in the same distance between the two groups(P>0.05).AC/A in the non-myopic group(5.40±2.23)was higher than that in the myopic group(3.14±3.10,P<0.05).Patients in the myopic group had better near stereopsis than the non-myopic group(P<0.05).The non-myopic group had a variety of surgical methods,while the myopic group mostly used lateral rectus resection or/and medial rectus recession.CONCLUSION:AACE can occur in different refractive status.Non-myopic patients have the same degree of distant and near strabismus,high AC/A,and varied surgical methods.However,myopic patients have less degree of near deviation than distant deviation and have normal AC/A and better near stereopsis,and lateral rectus resection or/and medial rectus recession are commonly used.

关 键 词：急性共同性内斜视 屈光状态 斜视度 视功能 

分 类 号：R777.41[医药卫生—眼科]