先天性内斜视的临床表现和手术治疗

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1、中国实用眼科杂志2006年7月第24卷第7期ChinJPractOphthalmol,July2006,Vol24,No.7725论著先天性内斜视的临床表现和手术治疗邹云春刘陇黔彭海鹰李平惠摘要目的了解先天性内斜视的临床特征和手术治疗方法及疗效方法回顾分析2000年10月至2003年12月我院斜视住院病人中132例先天性内斜视病例的临床资料及治疗结果所有病例接受三棱镜眼球运动检查大龄合作患儿同时行同视机线状镜等检查手术方法以对称性双眼内直肌后退为主斜视度较大者同时行一眼外直肌缩短如果有垂直斜视先行垂直肌肉手术矫正术后随访时间648个月平均24个月结果先天性内斜视多数患者

2、就诊年龄在1岁以后弱视发生率较小内斜视度较大多在4060之间眼外肌功能多表现为双眼运动时内直肌功能过强本组资料中113例患者手术后达到临床治愈一次手术临床治愈率86.3%结论先天性内斜视多为双眼交替性斜视度较大需要手术治疗一旦明确诊断应尽早手术可获得满意效果关键词内斜视先天性临床特点手术ClinicalfeaturesandsurgicaltreatmentofcongenitalesotropiaZOUYun-chun,LIULong-qian,PENGHai-ying,etal.DepartmentofOphthalmology,WestChinaHospital,

3、SichuanUniversity.Chengdu610041,ChinaAbstractObjectiveToinvestigatetheclinicalcharacteristicsandthemethodsandeffectofsurgicaltreatmentofcongenitalesotropia.MethodsTheclinicaldataandtheresultsofthetreatmentof132inpatientswithcongenitalesotropiainourdepartmentfromOct2000toDec2003wereretros

4、pectivelyanalyzed.Allofthepatientsunderwenttheexaminationwiththree-prismandeyemovementtestandtheexaminationswithsynoptophoreandstreakretinoscoopewereperformedontheelderchildrenadditionally.Thesurgicalproce-duresmainlyincludedsymmetricalrecessionofbinocularmedialrecti,andcombinedshortenin

5、gofmonocularlateralrectusinpatientwithhighdegreeofstrabismus.Verticalmuscleoperationwouldbeperformedfirstlyonthepatientwithverticalstrabismus.Thefollow-upperiodlastedfor6to48months,withthemeanof24months.ResultsMostofthepatientswithcongenitalesotropiawhentheywenttothehospitalwasmorethan1y

6、earold,whoseincidenceofamblyopiawaslowwhilethedeviateddegreeswerehigh(40-60).Theoveractionofmedial-rectifunctionwascommonlyseeninthesecases.In132patients,113recoveredafterthesurgerywiththeone-offcurativeratioof86.3%.ConclusionsMostofthepatientswithcongenitalesotropiawasbinocularalternati

7、onwithhighdeviateddegrees.Surgicaltreatmentshouldbeperformedearlyoncethediagnosisisconfirmedinordertogetthesatisfyingresults.Keywordsesotropia;congenital;clinicalcharacteristics;surgicaltreatment先天性内斜视又称婴儿型内斜视是指出生后效果进行分析半年内出现的内斜视是儿童斜视中常见的斜视类资料和方法型出生时内斜因素就已经存在但新生儿注视功能尚不稳定而