CAJ | 학술논문

目的：探讨眼外肌调整缝线矫正儿童部分调节性内斜视的临床疗效。 　　方法：选择30例部分调节性内斜视患儿行双眼内直肌后徙联合调整缝线手术。患儿术前为中度远视，且术前配戴足度镜矫正屈光不正＞6 mo，非调节部分的斜视度稳定在＋20△～＋35△范围内。术中双内直肌后退3～5 mm，保留1～2 mm缝线调整量，术后第1 d根据眼位调整缝线。术后1wk；1，3，6，12mo随访，观察眼位、残余斜视度和视功能情况。 　　结果：术后第1 d缝线原位眼位即达正位22例，6例过矫，2例欠矫，正位率为73％。经过缝线调整，正位率达到100％。术后1wk；1，3，6，12mo残余视近斜视度分别为＋5．9△±2．8△，＋4．4△±4．3△，＋3．8△±3．6△，＋2．9△±3.5△，＋2．7△±4．1△，视远斜视度分别为＋5．6△±3．2△，＋4．0△±3．1△，＋3．4△±3．4△，＋2．5△±3．4△，＋2．3△±3．9△。术后1，6，12 mo分别与术后1 wk比较，差异均无统计学意义（ P＞0．05）。术前有双眼单视功能者13例（43％），术后有双眼单视功能者23例（77％），差异有统计学意义（P＜0．05）。 　　结论：调整缝线的手术方式可以更准确的一次性矫正部分调节性内斜视，有效的减少术后过矫或欠矫问题。
목적：탐토안외기조정봉선교정인동부분조절성내사시적림상료효。 　　방법：선택30례부분조절성내사시환인행쌍안내직기후사연합조정봉선수술。환인술전위중도원시，차술전배대족도경교정굴광불정＞6 mo，비조절부분적사시도은정재＋20△～＋35△범위내。술중쌍내직기후퇴3～5 mm，보류1～2 mm봉선조정량，술후제1 d근거안위조정봉선。술후1wk；1，3，6，12mo수방，관찰안위、잔여사시도화시공능정황。 　　결과：술후제1 d봉선원위안위즉체정위22례，6례과교，2례흠교，정위솔위73％。경과봉선조정，정위솔체도100％。술후1wk；1，3，6，12mo잔여시근사시도분별위＋5．9△±2．8△，＋4．4△±4．3△，＋3．8△±3．6△，＋2．9△±3.5△，＋2．7△±4．1△，시원사시도분별위＋5．6△±3．2△，＋4．0△±3．1△，＋3．4△±3．4△，＋2．5△±3．4△，＋2．3△±3．9△。술후1，6，12 mo분별여술후1 wk비교，차이균무통계학의의（ P＞0．05）。술전유쌍안단시공능자13례（43％），술후유쌍안단시공능자23례（77％），차이유통계학의의（P＜0．05）。 　　결론：조정봉선적수술방식가이경준학적일차성교정부분조절성내사시，유효적감소술후과교혹흠교문제。
AIM:To investigate the efficacy of adjustable suture on partial accommodative esotropia surgery in children. METHODS: Thirty children with partial accommodative esotropia were treated by the recession of binocular medial rectus combined adjustable suture.The inclusion criteria were medium hypermetropia, and having wear sufficient degree mirror no less than six months, residual nonaccommodative esotropia deviation of +20△ ~+35△. 3mm to 5mm recession of binocular medial rectus and 1mm to 2mm adjustable suture were kept in surgery. Suture was adjusted on the first day after surgery.The use of adjustable suture after surgery, deviation after surgery and binocular vision function were used to evaluate the efficacy during the follow up. RESULTS: Twenty-two children ( 73%) were within orthotropia, 6 children deficient correction and 2 children excessive correction. After adjustment, all children ( 100%) were within orthotropia. Residual strabismus degrees for 33cm and 6m were+5.9△±2.8△,+4.4△±4.3△,+3.8△±3.6△, +2.9△±3.5△, +2.7△±4.1△ and +5.6△±3.2△,+4.0△±3.1△, +3.4△±3.4△, +2.5△±3.4△, +2.3△±3.9△1-week, 1-month, 3-month, 6-month, 1-year after surgery respectively, without significant difference ( P>0.05 ). Thirteen children ( 43%) before surgery and 23 children (77%) after surgery had binocular vision, with significant difference(P<0.05). CONCLUSION: Adjustable suture perform operations can one-off correct partial accommodative esotropia more accurately, decrease the frequency of deficient correction and excessive correction efficiently.