眼轴测量对先天性斜视手术量的校正  

Corrective design by axial length for congenital strabismus

作　　者：李雨晴 宋德胜 金双 谢嘉铭 姚家奇[2] 陈志钧[2] Li Yuqing;Song Desheng;Jin Shuang;Xie Jiaming;Yao Jiaqi;Chen Zhijun(Department of Ophthalmology,Women’s Hospital of Nanjing Medical University(Nanjing Women and Children’s Healthcare Hospital),Nanjing 210000,China;Department of Ophthalmology,Children’s Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院),210000 [2]南京医科大学附属儿童医院,210000

出　　处：《临床眼科杂志》2024年第5期412-417,共6页Journal of Clinical Ophthalmology

摘　　要：目的参照眼轴测量结果设计先天性内/外斜视手术量,比较先天性斜视常规手术量与校正手术量的矫正效果差异。方法回顾性临床研究。2017年2月至2022年6月在南京医科大学附属儿童医院行斜视矫正手术的254例先天性内/外斜视患儿。依据手术设计方式划分为A组127例,B组127例,A组单纯以斜视度按常规设计手术量,B组根据眼轴长度对以斜视度设计的手术量进行校正。对A、B组术后1周、3个月、6个月手术效果进行比较。结果(1)组间正位率比较,术后1周,A、B组正位率分别为84.3%、85.8%,差异无统计学意义(P>0.05),术后3个月,B组正位率78.0%,比A组66.9%高,差异有统计学意义(P<0.05),术后6个月,B组正位率76.9%,比A组63.5%高,差异有统计学意义(P<0.05)。(2)当眼轴<22 mm时,A、B两组术后1周的正位率分别为84.0%、85.2%,术后3个月的正位率分别为64.9%、78.4%,术后6个月的正位率分别为63.8%、77.3%。当眼轴≥22 mm且<26 mm时,A、B两组术后1周的正位率分别为84.8%、87.2%,术后3个月的正位率分别为72.7%、76.9%,术后6个月的正位率分别为60.6%、69.2%。当眼轴<22 mm时,两组术后1周正位率差异无统计学意义(P>0.05),术后3个月、术后6个月均有统计学差异(均P<0.05),当眼轴≥22 mm且<26 mm时,两组术后1周、3个月、6个月正位率差异无统计学意义(均P>0.05)。(3)组间手术满意度比较,B组满意度83.5%比A组69.3%高,差异有统计学意义(P<0.05)。结论在排除其它影响因素下,根据眼轴长度对传统手术量进行校正有利于提高先天性斜视的术后效果和手术满意度。该方法可为斜视手术量设计提供参考。Objective To compare the postoperative effect of congenital esotropia and congenital exotropia in routine surgery design and corrective design by axial length.Methods A retrospective study was conducted on 254 children with congenital strabismus who underwent strabismus correction surgery in Children’s Hospital of Nanjing Medical University from February 2017 to June 2022.They were divided into two groups:group A(127 cases)received surgical amount designed by deviating degree,while group B(127 cases)received surgical amount corrected according to axial length.The surgical effects of both groups were compared at 1 week,3 months,and 6 months after the surgery.Results(1)Regarding the comparison of the postoperative effects between the two groups,at 1 week after the surgery,the rates for group A and B were 84.3%and 85.8%,respectively(P>0.05).At 3 and 6 months after the surgery,the rates for group B(78.0%and 76.9%,respectively)were higher than those for group A(66.9%and 63.5%,respectively)(P<0.05).(2)When the axial length was less than 22 mm,the rates for groups A and B at 1 week after the surgery were 84.0%and 85.2%,respectively.At 3 months after the surgery,they were 64.9%and 78.4%,respectively.At 6 months after the surgery,they were 63.8%and 77.3%,respectively.When the axial length was between 22 mm and 26mm,the rates for groups A and B at 1 week after the surgery were 84.8%and 87.2%,respectively.At 3 months after the surgery,they were 72.7%and 76.9%,respectively.At 6 months after the surgery,they were 60.6%and 69.2%,respectively.When the ocular axial length was less than 22 mm,there was no statistically significant difference between the two groups at 1 week after the surgery(P>0.05),while there was a statistically significant difference at 3 and 6 months after the surgery(P<0.05).When the axial length was between 22 mm and 26 mm,there was no statistically significant difference between two groups(P>0.05).(3)Regarding the comparison of surgical satisfaction between the two groups,the satisfaction rate for group

关 键 词：眼轴 斜视 手术设计 术后效果 

分 类 号：R779.6[医药卫生—眼科]