非对称性手术矫正共同性斜视的临床分析

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1、非对称性手术矫正共同性斜视的临床分析【摘要】目的：观察非对称性手术矫正共同性斜视的疗效。方法：选择138例共同性斜视患者，其中包括共同性外斜视88例，共同性内斜视50例，合并垂直斜视度<7△的20例，合并轻度眼球隐性震颤的4例。其中外斜视平均斜视度30△～65△，内斜视平均斜视度30△～70△。所有患者均经过屈光矫正，弱视治疗视力提高至0.8以上，或双眼视力平衡0.6以上，同视机检查视功能，内斜患者戴镜矫正6mo以上。三棱镜检查33cm和5m斜视度差值≤15△的基本型斜视患者，斜视度在30△～70△的行单眼水平

2、肌肉后徙加缩短的非对称性手术。术后1wk年龄在6～14岁的做10d同视机功能训练。结果：术后1mo复查：矫正正位126例，欠矫8例，过矫2例，垂直斜视度变化不大，复视2例。术后3mo复查:矫正正位128例，欠矫8例，过矫1例，复视1例。同视机检查三级功能：术后做过功能训练的Ⅰ,Ⅱ,Ⅲ级视功能建立，Ⅰ级视功能建立35例，Ⅱ级视功能建立58例，Ⅲ级视功能建立45例。结论：非对称性手术矫正共同性斜视效果满意，儿童术后行功能训练有助于早日恢复视功能。【关键词】非对称性手术;共同性斜视;功能训练　　AbstractAIM:To

3、observetheeffectoftheasymmetricalsurgeryforconcomitantstrabismusMETHODS:Totally138patientswithconcomitantstrabismuswereanalysed,incluing888casesconcomitantexotropiaand50casesconcomitantesotropia,20casescombinedwithverticalslantdegree<7△,and4caseswithmildeye

4、ballrecessivenesstrembles.Theaverageslantdegreeofexotropiawas30△65△,andthatofesotropiawas30△70△.Aftertherefractionandamblyopiatreatment,thevisualacuityofallpatientswasimprovedto>0.8,orthebalancevisionofbinocularimprovedto0.6,visualfunctionwasinspectedwiths

5、ynoptophoreandesotropiapatientswerecorrectedbywearingglassesfor>halfyear.Strabismuspatientswiththedifferenceof33cmand5mslantvisualdegree≤15△andslantvisualdegreewithin30△70△bytripleprismunderwenttheasymmetricalsurgerycombinedwiththesimpleeyehorizontalmusclew

6、ithdrawalandreduction.Thefunctiontrainingbysynoptophorewereperformedfor10daysforpatientsagedfrom614yearsold1weekafteroperation.RESULTS:Onemonthafteroperation:126caseswerecorrected;8caseswereundercorrected;2caseswereovercorrected;2caseswerediplopia,verticalsla

7、ntdegreewasnotchanged.Threemonthsafteroperation:128caseswerecorrected;8caseswereundercorrected;1casewasovercorrected;1casewasdiplopia.Synoptophoreinspection:Ⅰ,ⅡandⅢlevelsvisualfunctionswererecoveredafterthefunctiontraining,includingⅠlevel358cases,Ⅱlevel58casesa

8、ndⅢlevel45cases.CONCLUSION:Theasymmetricalsurgeryhasasatisfiedeffectforconcomitantstrabismus.Functiontrainingafteroperationishelpfultorestorevisualfunction.　　KEYWORDS:asym