方法：观察我院2013-09/2014-09期间-10°～-15°间歇性外斜视(intermittent exotropia，IXT)手术的患者206例，术前均行视力、屈光状态、主导眼、主斜眼、单眼遮盖1h后33cm及6m三棱镜加遮盖法检查最大斜视度、同视机和Titmus立体视图查近立体视。其中，基本型132例，集合不足型61例(33cm和6m三棱镜加遮盖法检查>10^△～20^△者40例，>20^△者21例)，分开过强型13例(33cm和6m三棱镜加遮盖法检查>10^△～20^△者7例，>20^△者6例)。手术方式：基本型132例分3组：52例行主斜眼(非主导眼)一退一截术(nondominant eye unilateral recess-resection，ndR& R)，40例行主导眼一退一截术(dominant eye unilateral recess-resection，dR& R)，40例行双眼外直肌后徙术(bilateral lateral rectus recession，BLR-rec)。集合不足型和分开过强型33cm和6m斜视度相差>10^△～20^△的47例患者，均采用dR& R。集合不足型和分开过强型斜视度相差>20^△的27例患者，分别采用双眼内直肌缩短术(bilateral medial rectus amputation，BMR-amp)和BLR-rec。术后随访1、6、12、24mo，观察术后正位率、欠矫及过矫情况，对各型组内和组间的手术方式进行比较和评价。观察-10°～-15° IXT的临床特征、手术前后同视机及立体视的变化。

结果：所有206例-10°～-15° IXT患者的临床特征：年龄集中在5～12岁，主斜眼为左眼且多为裸眼视力较差眼，双眼屈光状态以单纯近视、散光和屈光参差多见，基本型为最常见类型，斜视度以>40^△～60^△者为多，可存在一定程度的同视机三级功能和近立体视。手术方式的比较：(1)基本型132例比较：在术后12mo和24mo，ndR& R组和dR& R组与BLR-rec组正位率差异均有统计学意义(P<0.05)。(2)集合不足型两组术后正位率在1、6、12、24mo比较，差异均无统计学意义(P>0.05)。(3)分开过强型两组手术疗效确切。基本型和集合不足型ndR& R组术后6、12、24mo正位率比较，差异有统计学意义(P<0.05)。患者术后随访中，同视机和近立体视得到部分改善。

结论：-10°～-15° IXT患者临床特征明显，应根据具体检查结果制定个性化的手术方案。手术治疗有利于双眼单视功能的恢复和立体视的建立，成人外斜手术可改善外观，减轻视疲劳。206例患者中，采用等量或不等量dR& R治疗各型-10°～-15° IXT手术效果明确； 33cm和6m斜视度相差>20^△的集合不足型和分开过强型-15°～-20° IXT，采用BMR-amp和BLR-rec疗效确切。

METHODS:Totally 206 in-patients with small-diopter intermittent exotropia(IXT)in different operation groups, from September 2013 to September 2014,were observed for the eyesight, refraction, dominant eye, exotropia degree, synoptophore and near stereopsis before and after operation. Three types were divided in 206 cases. One hundred and thirty-two cases of basic IXT were the first type, in which 52 cases underwent nondominant eye unilateral recess-resection(nondominant eye unilateral recess-resection, ndR& R), 40 cases underwent dominant eye unilateral recess-resection(dominant eye unilateral recess-resection, dR& R), 40 cases underwent bilateral lateral rectus recession(bilateral lateral rectus recession, BLR-rec). Sixty-one cases of convergence insufficiency IXT were the second type, in which 40 cases underwent ndR& R, 21 cases underwent bilateral medial rectus amputation. Thirteen cases of divergence excess IXT were the third type, in which 7 cases underwent ndR& R, 6 cases underwent BLR-rec. The rates of the orthophoria, undercorrection, overcorrection and the recovery of synoptophore and near stereopsis after surgery in 1, 6, 12, 24mo were compared in 3 types.

RESULTS: The clinical features of 206 cases with small-diopter IXT were: in the most cases, between 5 and 12 years old; nondominant eye was left eye; the eyesight of nondominant eye was lower than another eye; refraction status were myopia, astigmatism and anisometropia; basic IXT was the most common type; exotropia degree was between 40^△ and 60^△; some cases owned binocular function and near stereopsis. Comparison of operation methods in 3 groups: orthophoria comparisons in basic IXT among ndR& R group, d R& R group and BLR-rec group were significant difference(P<0.05)after operation in 12 and 24mo. Orthophoria comparison in insufficiency IXT between ndR& R group and BMR-amp group was not significant difference(P>0.05)after operation. The operation of divergence excess IXT was effective. Orthophoria comparison in ndR& R group between basic IXT and convergence insufficiency IXT was significant difference(P<0.05)after operation in 6, 12 and 24mo. Synoptophore and near stereopsis of some cases were improved after operation.

CONCLUSION:Early surgical treatment of the pediatric patients with small-diopter IXT is benefit for the establishment of binocular function and stereopsis. Adult surgical treatment can improve the appearance and alleviated eyestrain. In 206 cases, the operation method of ndR& R is obvious curative effective in each type of small-diopter IXT. The operation methods of BMR-amp and BLR-rec are obvious effective in insufficiency intermittent and divergence excess IXT.