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[摘要]
目的:分析知觉性斜视的临床特点及手术效果。
方法:分析2012-01/2013-06我科收治的178例知觉性斜视患者的临床资料,包括知觉性斜视的类型,斜视眼视力障碍的病因,斜视度数分布,观察术后眼位及复视现象。
结果:知觉性斜视178例中知觉性外斜视123例(69.1%),知觉性内斜视55例(30.9%),知觉性斜视中109例为屈光参差性弱视,123例知觉性外斜视的平均斜视度为69.32△,其中78例合并垂直斜视,55例知觉性内斜视的平均斜视度为56.45△,其中26例合并垂直斜视。术毕6例患者出现复视,均于2wk内消失。手术设计按内斜欠矫10△左右,外斜过矫10△左右,术后眼位±10△内为正位,所有患者均行斜视眼手术,超过60△者按超常量一截一退手术设计,术后1a随访,178例斜视患者中138例术后眼位达到正位。
结论:知觉性外斜视较知觉性内斜视更为常见,知觉性斜视最常见的病因为屈光参差性弱视,通常斜视度数较大,且常合并垂直斜视,知觉性斜视手术可以较好的改善斜视外观,提高患者生活质量。
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[Abstract]
AIM: To investigate the clinical features and evaluate the surgical effect for sensory strabismus.
METHODS: Clinical data of 178 patients with sensory strabismus that we treated from January 2012 to June 2013 were collected, including type of strabismus, cause of vision loss, degree distribution of strabismus. The ocular alignments and diplopia after surgery were observed.
RESULTS: Among the 178 patients with sensory strabismus, 123 cases(69.1%)had sensory exotropia and 55(30.9%)had sensory esotropia, 109 patients had anisometropic amblyopia. The mean preoperative exotropia deviation of the 123 patients with sensory exotropia was 69.32△. In the 123 patients, 78 were complicated with vertical deviation. The mean preoperative esotropia deviation of the 55 patients with sensory esotropia was 56.45△. In the 55 patients, 26 were complicated with vertical deviation. Six patients suffered from diplopia but diplopia disappeared within 2wk after surgeries. The operation was designed to overcorrect the sensory exotropia and undercorrect the esotropia both about 10△. The postoperative ocular position was considered alignment if the position was ±10△. All patients were performed surgeries.For patients with large-angle of sensory strabismus over 60△, super maximal rectus resection and rectus recession operation were chosen. The follow-up time was 1a. The operations were successful in 138 patients in the all 178 patient who experienced surgeries.
CONCLUSION: The most common type of sensory strabismus was exotropia, and the most common cause of strabismus was anisometropic amblyopia. The angels of sensory strabismus were usually large, and often complicated with vertical strabismus. Sensory strabismus surgery can improve the appearance and the life quality of the patients.
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