摘要
目的 :探讨先天性上斜肌麻痹术后正位的代偿头位、Bielschowsky征及双眼视觉的恢复规律。方法 :对 36例先天性上斜肌麻痹经手术治疗后 ,眼位达正位者 (原在位垂直斜视度≤ 5 △)的临床资料进行分析。结果 :①术前 36例中 ,伴代偿头位 2 6例 ,术后代偿头位消失 14例 (5 3 8% ) ,好转 12例 (4 6 2 % ) ,头位消失时间为术后 1天至术后 3个月 ,平均 33 8天。②术后Bielschowsky征阴性 2 5例 (6 9 4 % ) ,阳性 11例 (30 6 % )。③术前存在同时知觉、融合功能、远立体视、近立体视者分别为 7例 (19 4 % ) ,6例 (16 7% ) ,3例 (8 3% ) ,1例 (2 8% ) ;术后存在同时知觉、融合功能、远立体视、近立体视者分别为 31例(86 1% ) ,2 9例 (80 6 % ) ,2 2例 (6 1 1% ) ,10例 (2 7 8% )。结论 :①先天性上斜肌麻痹伴代偿头位者仅部分有双眼视功能。②评判术后代偿头位消失与否 ,至少应观察 1个月以上。③Bielschowsky征阴性不应作为评判上斜肌麻痹治愈的绝对标准。
Objective:To study the characteristics of compensatory head posture,Bielschowsky sign and binocular vision of postoperative patients with congenital superior oblique palsy(CSOP).Methods:Data of 36 postoperative patients with CSOP were analysed.The hyperdeviation in primary position was ≤5 △.Results:①26 of the 36 patients had abnormal head tilt preoperatively,while 14 cases (53.8%) had no abnormal head tilt and 12 cases (46.2%)improved postoperatively.The average time that abnormal head tilt began to disappear from surgery was 33.8 days with a range of 1 day to 3 months.②Postoperative negative and positive Bielschowsky sign were 25 cases(69.4%)and 11 cases (30.6%)respectively.③Preoperative occurring simultaneous perception,fusion,distance stereoacuity and near stereoacuity were 7 cases (19.4%),6 cases (16.7%),3 cases (8.3%)and 1 case (2.8%)respectively.Postope-rative occurring simultaneous perception,fusion,distance stereoacuity and near stereoacuity were 31 cases (86.1%),29 cases (80.6%),22 cases (61.1%),10 cases (27.8%)respectively.Conclusions:①Not all of the CSOP patients with abnormal head posture have binocular vision.②It should take at least one month to evaluate whether the abnormal head posture can disappear.③Negative Bielschowsky sign should not be an absolute criterion for surgical success.
出处
《眼科》
CAS
2004年第1期35-37,共3页
Ophthalmology in China
