间歇性外斜视矫正手术前后近立体视的影响因素  

Influencing factors of near stereopsis before and after corrective surgery for intermittent exotropia

作　　者：张灿灿 周炼红[1] 鲁翼 龚奇 余露润 段欧文 袁庆 Zhang Cancan;Zhou Lianhong;Lu Yi;Gong Qi;Yu Lurun;Duan Ouwen;Yuan Qing(Department of Ophthalmology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院眼科中心,武汉430060

出　　处：《中华眼外伤职业眼病杂志》2024年第10期729-735,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：湖北省重点研发计划项目(2022BCA044)。

摘　　要：目的分析间歇性外斜视患者矫正术前和术后近立体视功能的影响因素。方法回顾性队列研究。收集武汉大学人民医院2021年9月至2023年9月行斜视矫正术的间歇性外斜视的患者243例临床资料,术后半年随访患者病例资料206份,所有患者均应用Titmus立体视图检查近立体视功能。应用卡方检验、秩和检验判断间歇性外斜视患者近立体视影响因素及术后与术前近立体视差异。并应用累积优势logistic回归分析影响效应的大小。结果术前正常近立体视、近立体视减退和无近立体视者分别占41.98%(102/243)、35.39%(86/243)和22.63%(55/243)。患病年龄小[比值比(OR)=0.27,95%置信区间(CI):0.11~0.67,P=0.003]、病程时长久(OR=1.16,95%CI:1.06~1.28,P=0.035)、视近斜视度大(OR=1.03,95%CI:1.01~1.04,P=0.016)、视远斜视度大(OR=1.04,95%CI:1.00~1.07,P=0.018)、伴有垂直斜视度(OR=1.67,95%CI:1.01~2.76,P=0.024)、伴有远视(OR=1.97,95%CI:0.90~4.31,P=0.045)和伴有屈光参差(OR=2.91,95%CI:1.45~5.89,P=0.002)是术前近立体视损伤的危险因素。术后近立体视优于术前(χ^(2)=14.60,P<0.001)。患病年龄小(OR=0.23,95%CI:0.07~0.66,P=0.005)、病程时长久(OR=1.04,95%CI:1.01~1.08,P=0.012)和伴有屈光参差(OR=2.94,95%CI:1.40~6.25,P=0.002)是术后近立体视损伤的危险因素。结论间歇性外斜视患者患病年龄越小、病程时长越久、斜视度越大、伴有垂直斜视度、远视和屈光参差,术前立体视损伤越严重。患病年龄越小、病程时长越久和伴有屈光参差,术后近立体视损伤越严重。ObjectiveTo analyse the factors affecting near stereopsis in patients with intermittent exotropia before and after corrective surgery.MethodsA retrospective cohort study was conducted.The clinical data of 243 patients with intermittent exotropia undergone extraocular muscle transposition surgery in Renmin Hospital of Wuhan University from Sep.2021 to Sep.2023 were collected.There were 206 cases with a 6-month follow-up in the study.Near stereopsis was assessed using the Titmus stereopsis test.Chi-square test and Kruskal-Wallis rank-sum test were used to determine the factors affecting near stereopsis in patients with intermittent exotropia and the differences in near stereopsis before and after surgery.Cumulative odds logistic regression analysis was applied to determine the magnitude of these effects.ResultsThe proportions of patients with normal near stereopsis,reduced near stereopsis,and no near stereopsis before surgery were 41.98%(102/243),35.39%(86/243),and 22.63%(55/243),respectively.Younger age at onset[odds ratio(OR)=0.27,95%confidence interval(CI):0.11-0.67,P=0.003],longer duration of disease(OR=1.16,95%CI:1.06-1.28,P=0.035),greater near deviation(OR=1.03,95%CI:1.01-1.04,P=0.016),greater distant deviation(OR=1.04,95%CI:1.00-1.07,P=0.018),vertical deviation(OR=1.67,95%CI:1.01-2.76,P=0.024),hyperopia(OR=1.97,95%CI:0.90-4.31,P=0.045),and anisometropia(OR=2.91,95%CI:1.45-5.89,P=0.002)were risk factors for preoperative near stereopsis impairment.Postoperative near stereopsis was better than that preoperatively(χ^(2)=14.60,P<0.001).Younger age at onset(OR=0.23,95%CI:0.07-0.66,P=0.005),longer duration of disease(OR=1.04,95%CI:1.01-1.08,P=0.012),and anisometropia(OR=2.94,95%CI:1.40-6.25,P=0.002)were risk factors for postoperative near stereopsis impairment.ConclusionIn patients with intermittent exotropia,younger age at onset,longer duration of disease,greater deviation,vertical deviation,hyperopia,and anisometropia are associated with more severe preoperative near stereopsis impairment.Younger age at onset,lo

关 键 词：间歇性外斜视 立体视觉 参差 屈光 

分 类 号：R47[医药卫生—护理学]