摘要
目的了解儿童间歇性外斜视手术后的远期疗效并探讨手术后远期获得中心凹立体视的影响因素。方法对216例4。15岁的间歇性外斜视儿童进行斜视矫正手术，并于手术前、手术后1个月及手术后≥1年时行眼位、双眼视功能、近及远距离立体视锐度检查。术后远期平均随访3．68年。结果术后≥1年，216例中有90．74％的儿童获得≤60的近立体视锐度，74．07％的儿童获得≤60~的远立体视锐度，近、远距离中心凹立体视检出率差异无统计学意义。按手术年龄将患者分为≤6岁组、6-9岁组和≥9岁组，三组间术后远期近、远距离中心凹立体视锐度的检出率差异无统计学意义。术后远期有150例（69．44％）眼位正位，66例（30．56％）眼位欠矫，远期正位组与远期欠矫组≤60”的近立体视锐度检出率差异无统计学意义；远期正位组≤60“的远立体视锐度检出率为80．00％，远期欠矫组≤60”的远立体视锐度检出率为60．61％，两组间比较差异有统计学意义（x。=12．17，P〈0．01）。Logistic多因素回归分析结果显示，术后远期远距离中心凹立体视的检出率与术前患者是否存在远立体视锐度的密切相关。术后远期保持正位与检出中心凹立体视相关。结论儿童间歇性外斜视术后远期近、远距离立体视锐度均较术前有明显改善，且不受手术年龄影响。影响远距离中心凹立体视锐度形成的不良因素为远期眼位回退。术前存在远立体视有利于术后形成远距离中心凹立体视，故儿童间歇性外斜视的最佳手术时机应选择在远立体视丧失以前。
Objective To explore the long-term therapy effect of children intermittent exotropia after surgery and the impact factors of acquired foveolar stereoscopic vision. Methods A total of 216 children with intermittent exotropia aged 4-15 years were accepted the orthopia surgery. Before the surgery and 1 month or over 1 year after the surgery, position of eye, binocular vision and far and near stereoscopic vision were determined. The averaged years of following up were 3.68. Re- suits One year or longer after the surgery, 90.74% of all the children acquired the near stereoscopic vision less than 60 ＂, while 74.07% acquired the far stereoscopic vision less than 60 ＂. The far and near foveolar stereoscopic visions had no significant difference. According to the age of the pa- tients, they were divided into three groups, including less than 6 years old group, 6-9 years old group and more than 9 years old group. There was no significance in far and near foveolar stereo- scopic visions among the three groups. For a long time after operation, 150 （69.44%） patients were orthotopic, 66 （30.56%） patients were not fully orthotopic. The tested positive of near stereoscopic vi- sion less than 60 ＂ had no significance between orthotopic patients and nor fully orthotopic patients. The tested positive of the far stereoscopic vision less than 60 ＂ in orthotopic patients was 80.00%,while that in nor fully orthotopic patients was 60.61%. The difference of the test positive was signif- icant （x^2=12.17, P 〈0.01）. The logistic analysis showed that the tested positive of the far foveolar ste- reoscopic visions was associated with whether the patients were with far stereoscopic vision before surgery. Orthotopic maintain long-term after surgery was associated with the tested positive of foveo- lar stereoscopic vision. Conclusions The far and near stereoscopic vision are improved after chil- dren intermittent exotropia surgery without age influence. The impact factor of far foveolar stereo- scopic vision formation is eye position regression. The far stereoscopic vision before surgery is bene- ficial for foveolar stereoscopic vision formation after surgery. So the best opportunity for the surgery is before the loss of far stereoscopic vision.
出处
《中国实用眼科杂志》
CSCD
北大核心
2012年第10期1189-1192,共4页
Chinese Journal of Practical Ophthalmology
关键词
间歇性外斜视
儿童
立体视
手术
Intermittent exotropia
Children
Stereoscopic vision
Surgery
