中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2012年
1期
34-37
,共4页
吴其正%王晓明%王利华%马鲁新%孔冬
吳其正%王曉明%王利華%馬魯新%孔鼕
오기정%왕효명%왕리화%마로신%공동
外斜视,间歇性%眼外科手术%治疗结果%外直肌后徒术,单眼
外斜視,間歇性%眼外科手術%治療結果%外直肌後徒術,單眼
외사시,간헐성%안외과수술%치료결과%외직기후도술,단안
Exotropia,intermittent%Ophthalmologic surgical procedure%Treatment outcome%Lateral rectus muscle recession,unilateral
目的 探讨单眼外直肌后徙术对中、小度数儿童间歇性外斜视的疗效.方法 回顾性系列病例研究.2009年4月至2010年3月期间行单眼外直肌后徙术治疗、斜视度为15△～35△的间歇性外斜视儿童69例.采用三棱镜加交替遮盖法测定患儿注视6 m和33 cm的斜视度,根据看远斜视度定量行7～10 mm单眼外直肌后徙术,随访时间≥6个月.手术前后采用Worth四点灯检查中心和周边融合,采用Titmus立体视图测定立体视锐度.疗效评价标准以眼位-8△～0△为正位；第一眼位与侧向注视的斜视度相差≥10△为非共同性阳性.采用x2检验对数据进行分析.结果 术后1～3 d和≥6个月随访正位率分别为81％和62％,欠矫率分别为12％和36％.斜视度为30△、35△(外直肌后徙9.5～10 mm)者欠矫率较高.术前与术后远期随访比较,具有正常中心融合和周边融合者比例的差异有统计学意义(x2=21.9,P＜0.01；x2=14.0,P＜0.01),术后明显高于术前；具有正常立体视功能者比例的差异有统计学意义(x2=15.0,P＜0.01),术后明显高于术前.术后远期随访未见眼位非共同性阳性者.结论 单眼外直肌后徙术治疗斜视度为15△～25△的儿童间歇性外斜视安全、有效.
目的 探討單眼外直肌後徙術對中、小度數兒童間歇性外斜視的療效.方法 迴顧性繫列病例研究.2009年4月至2010年3月期間行單眼外直肌後徙術治療、斜視度為15△～35△的間歇性外斜視兒童69例.採用三稜鏡加交替遮蓋法測定患兒註視6 m和33 cm的斜視度,根據看遠斜視度定量行7～10 mm單眼外直肌後徙術,隨訪時間≥6箇月.手術前後採用Worth四點燈檢查中心和週邊融閤,採用Titmus立體視圖測定立體視銳度.療效評價標準以眼位-8△～0△為正位；第一眼位與側嚮註視的斜視度相差≥10△為非共同性暘性.採用x2檢驗對數據進行分析.結果 術後1～3 d和≥6箇月隨訪正位率分彆為81％和62％,欠矯率分彆為12％和36％.斜視度為30△、35△(外直肌後徙9.5～10 mm)者欠矯率較高.術前與術後遠期隨訪比較,具有正常中心融閤和週邊融閤者比例的差異有統計學意義(x2=21.9,P＜0.01；x2=14.0,P＜0.01),術後明顯高于術前；具有正常立體視功能者比例的差異有統計學意義(x2=15.0,P＜0.01),術後明顯高于術前.術後遠期隨訪未見眼位非共同性暘性者.結論 單眼外直肌後徙術治療斜視度為15△～25△的兒童間歇性外斜視安全、有效.
목적 탐토단안외직기후사술대중、소도수인동간헐성외사시적료효.방법 회고성계렬병례연구.2009년4월지2010년3월기간행단안외직기후사술치료、사시도위15△～35△적간헐성외사시인동69례.채용삼릉경가교체차개법측정환인주시6 m화33 cm적사시도,근거간원사시도정량행7～10 mm단안외직기후사술,수방시간≥6개월.수술전후채용Worth사점등검사중심화주변융합,채용Titmus입체시도측정입체시예도.료효평개표준이안위-8△～0△위정위；제일안위여측향주시적사시도상차≥10△위비공동성양성.채용x2검험대수거진행분석.결과 술후1～3 d화≥6개월수방정위솔분별위81％화62％,흠교솔분별위12％화36％.사시도위30△、35△(외직기후사9.5～10 mm)자흠교솔교고.술전여술후원기수방비교,구유정상중심융합화주변융합자비례적차이유통계학의의(x2=21.9,P＜0.01；x2=14.0,P＜0.01),술후명현고우술전；구유정상입체시공능자비례적차이유통계학의의(x2=15.0,P＜0.01),술후명현고우술전.술후원기수방미견안위비공동성양성자.결론 단안외직기후사술치료사시도위15△～25△적인동간헐성외사시안전、유효.
Objective To investigate the long-term surgical outcome of unilateral lateral rectus recession for small-to-moderate angle intermittent exotropia in children.Methods Sixty-nine children with intermittent exotropia (15△-35△) who underwent unilateral lateral rectus recession during April 2009 to March 2010 were retrospectively reviewed.The exodeviations were measured by the alternate prism cover test at both distance (6 m) and near (33 cm) with fixation on accommodative targets.An amount of 7-10 mm unilateral lateral rectus recession was performed according to the quantity of distance deviation.The Worth 4-Dot test was employed both at distance and near fixation to assess central and peripheral fusion,respectively.The Titmus stereo test was used to assess stereoacuity.A successful alignment was defined as -8△-0△ in primary gaze while viewing distant and near targets.There was a minimum of 6 months follow-up period.Incomitance was defined as a change of more than 10△ from primary to lateral gaze.The data were analyzed with a chi-square test.Results The successful rates in alignment at 1-3 days postoperative and final follow-up periods were 81％ and 62％,and the undercorrection rates were 12％ and 36％,respectively.The patients who underwent an amount of 9.5 mm and 10 mm unilateral lateral rectus recession had a higher undercorrection rate at the final followup.The number of patients with normal central fusion,peripheral fusion and stereoacuity at final examination increased statistically compared to the preoperative number (x2=21.9,14.0,15.0,P＜0.01).None of the patients had clinically significant lateral incomitance at the final followup.Conclusion Unilateral lateral rectus recession is a safe and effective treatment for intermittent exotropia in children with exodeviation measuring 15△ to 25△.
