中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2015年
3期
255-258
,共4页
刘静%杨先%徐婷婷%王园%孔庆兰%李慧%刘桂波
劉靜%楊先%徐婷婷%王園%孔慶蘭%李慧%劉桂波
류정%양선%서정정%왕완%공경란%리혜%류계파
先天性内斜视%手术%眼位%双眼视功能
先天性內斜視%手術%眼位%雙眼視功能
선천성내사시%수술%안위%쌍안시공능
Congenital esotropia%Postoperative%Eye position%Binocular vision
目的 观察先天性内斜视患者的临床特征及手术治疗后远期效果.方法 回顾性临床病例系列研究.对2008年1月至2013年1月在青岛大学附属医院眼科追踪观察85例先天性内斜视患者的临床特征及手术方法.其具体分为:双侧内直肌后徙术、单侧内直肌后徙术、双侧内直肌后徙联合单侧外直肌缩短术.按手术年龄分为<4岁组、4~8岁组和>8岁组,观察术后远期眼位、双眼视功能,分析治疗效果,探讨手术时机及手术效果的影响因素.结果 先天性内斜视多为非调节性内斜视;伴有弱视和下斜肌功能亢进可能影响术后远期眼位;年龄<4岁组术后双眼视功能的改善明显优于4~8岁组和>8岁组;术后建立的双眼视反应,即粗糙立体视和周边融合可较好地帮助维持术后眼位.结论 先天性内斜视患者4岁前手术双眼视功能恢复情况明显优于4岁后手术者,且术后建立的双眼视反应如粗糙立体视和Worth四点融合可较好地帮助维持术后眼位.先天性内斜视患者的手术治疗若处于视觉系统发育的关键期内,其远期疗效较好.
目的 觀察先天性內斜視患者的臨床特徵及手術治療後遠期效果.方法 迴顧性臨床病例繫列研究.對2008年1月至2013年1月在青島大學附屬醫院眼科追蹤觀察85例先天性內斜視患者的臨床特徵及手術方法.其具體分為:雙側內直肌後徙術、單側內直肌後徙術、雙側內直肌後徙聯閤單側外直肌縮短術.按手術年齡分為<4歲組、4~8歲組和>8歲組,觀察術後遠期眼位、雙眼視功能,分析治療效果,探討手術時機及手術效果的影響因素.結果 先天性內斜視多為非調節性內斜視;伴有弱視和下斜肌功能亢進可能影響術後遠期眼位;年齡<4歲組術後雙眼視功能的改善明顯優于4~8歲組和>8歲組;術後建立的雙眼視反應,即粗糙立體視和週邊融閤可較好地幫助維持術後眼位.結論 先天性內斜視患者4歲前手術雙眼視功能恢複情況明顯優于4歲後手術者,且術後建立的雙眼視反應如粗糙立體視和Worth四點融閤可較好地幫助維持術後眼位.先天性內斜視患者的手術治療若處于視覺繫統髮育的關鍵期內,其遠期療效較好.
목적 관찰선천성내사시환자적림상특정급수술치료후원기효과.방법 회고성림상병례계렬연구.대2008년1월지2013년1월재청도대학부속의원안과추종관찰85례선천성내사시환자적림상특정급수술방법.기구체분위:쌍측내직기후사술、단측내직기후사술、쌍측내직기후사연합단측외직기축단술.안수술년령분위<4세조、4~8세조화>8세조,관찰술후원기안위、쌍안시공능,분석치료효과,탐토수술시궤급수술효과적영향인소.결과 선천성내사시다위비조절성내사시;반유약시화하사기공능항진가능영향술후원기안위;년령<4세조술후쌍안시공능적개선명현우우4~8세조화>8세조;술후건립적쌍안시반응,즉조조입체시화주변융합가교호지방조유지술후안위.결론 선천성내사시환자4세전수술쌍안시공능회복정황명현우우4세후수술자,차술후건립적쌍안시반응여조조입체시화Worth사점융합가교호지방조유지술후안위.선천성내사시환자적수술치료약처우시각계통발육적관건기내,기원기료효교호.
Objective To observe the clinical features and the long-term efficacy after surgery of congenital esotropia.Methods A retrospective study.Clinical data of 85 cases with congenital esotropia were reviewed and analyzed their clinical features and surgical methods,the surgical methods included bilateral medial rectus recession,unilateral medial rectus recession,bilateral medial rectus recession and unilateral lateral rectus resection.According to surgical ages all cases were divided into < 4,4~8 years old group and > 8 groups.Long-term eye position and binocular vision were observed.The timing and the factors effect were investigated and analyzed postoperatively.Results Congenital esotropia mostly not accommodative esotropia;with amblyopia and inferior oblique overaction may influence the postoperative long-term eye position;the recovery of postoperative binocular vision:aged <4 groups was obviously better than the 4~8 years old group and >8 groups;the binocular visual reaction originally settled up after surgery such as Rough vertical and Worth four fusion could help maintain good postoperative eye position.Conclusions In congenital esotropia,the rate of achieving binocular vision in the group of surgery before 4 years old is significantly higher than that of after 4 years old,and the binocular visual reaction such as Rough vertical and Worth four fusion can help maintain good postoperative eye position postoperatively.When cases with congenital esotropia obtain operation in critical period of vision development the long-term efficacy is good.