目的：通过分析共同性斜视矫正手术前后双眼总和图形视觉诱发电位的变化，探讨共同性斜视手术时机及其在斜视性弱视治疗中的作用。

方法：回顾性分析18岁以内在院接受共同性斜视矫正术治疗，且术后斜视矫正正位(斜视度≤±10^△)的病历资料67例。按手术前斜视类型、接受手术时年龄、弱视程度分组，对各组术前、术后1，3mo分别进行双眼总和P-VEP检测。结果以双眼反应/单眼反应(B/M)比值作为评价指标。

结果：所有病例术后1mo B/M值均升高，差异有显著统计学意义(P<0.01)。其中(1)内斜视组术后3mo的B/M值升高较外斜视组明显(P<0.05)；(2)≤6岁组，术后3mo B/M值升高较>12岁组明显(P<0.05)。(3)重度弱视组术后1mo的B/M值升高较轻度弱视组明显(P<0.05)； 术后3mo，重度弱视组B/M值升高较轻度、中度弱视组明显(P<0.01)。

结论：经过弱视治疗后视力仍难以提高的共同性斜视患者建议6岁前行斜视矫正手术，特别是重度弱视及内斜视患儿(调节性内斜视除外)。早期手术有利于弱视的进一步治疗及双眼视功能的恢复。

AIM: To investigate the opportunity of the concomitant strabismus operation and the function in the treatment of strabismic amblyopia through analyzing the changes of binocular summation of pattern visual evoked potential(P-VEP)before and after the surgery of concomitant strabismus.

METHODS: In this retrospective study we investigated 67 cases admitted in our hospital. All patients were less than 18a and the postoperation squint angle was less than ±10^△. Patients were divided into three groups according to the strabismus type, age, and amblyopia degree. P-VEP binocular summation response was recorded in all cases, to observe the changes of the binocular summation response of P-VEP before strabismus surgery and 1mo, 3mo after surgery. The P-VEP response of binocular /monocular(B/M)ratio was taken as an evaluation index.

RESULTS: B/M value of three groups all improved obviously 1mo after surgery, which the difference showed statistical significant(P<0.01). 1)After 3mo surgery, B/M value in esotropia group was higher than that in exotropia group(P<0.05). 2)After 3mo surgery, B/M value in ≤6a group was higher than that in >12a group(P<0.05). 3)After 1mo surgery, B/M value in severe amblyopia group was higher than that in mild group(P<0.05). After 3mo surgery, B/M value in severe amblyopia group was higher than that in mild group significantly(P<0.01).

CONCLUSION: Concomitant strabismus surgery is suggested to be performed before 6 years old when the patients are difficult to improve the vision after amblyopia treatment, especially with the severe amblyopia and esotropia(accommodative esotropia must be excluded). The early operation is better to amblyopia treatment and binocular vision recovery.

广西壮族自治区卫生厅自筹课题(No.Z2007233)