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[摘要]
目的:探讨双眼外直肌倾斜后徙术治疗集合不足型间歇性外斜视的疗效及安全性。
方法:选取2017-10/2019-11在我院就诊的集合不足型间歇性外斜视患者29例行双眼外直肌倾斜后徙术治疗,术后随访6mo,观察斜视度的变化、手术正位率、双眼视功能及并发症情况。
结果:本组患者术前看近斜视度-41.72±3.35PD,看远斜视度-23.28±9.75PD,看近-看远斜视度差值16.90±2.47PD,术后6mo分别为-5.97±4.85、-2.66±4.78、3.28±1.10PD,手术总体正位率76%。术后6mo,Ⅰ、Ⅱ级视功能恢复比例均较术前提高(P<0.05),远立体视、近立体视恢复较术前均无显著差异(P>0.05)。所有患者术后均未出现A-V综合征、眼球运动受限、限制性斜视、垂直斜视、旋转复视等并发症,部分患者术后出现短暂水平复视,均在术后2~3wk内消失。
结论:双眼外直肌倾斜后徙术能减少看近、看远斜视度及看近-看远斜视度差值,未发现明显并发症,是一种安全有效的治疗集合不足型间歇性外斜视的手术方式。
[Key word]
[Abstract]
AIM:To observe curative effect and safety of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia.
METHODS:This study included 29 patients who underwent slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia in our hospital between October 2017 and November 2019 with a follow-up of 6mo, the deviation, the surgical success rate, the binocular vision function and the complications were observed.
RESULTS:In our study, the mean near deviations, the mean distance deviations and the near-distance deviation differences reduced from -41.72±3.35PD, -23.28±9.75PD and 16.90±2.47PD before surgery to -5.97±4.85PD, -2.66±4.78PD, 3.28±1.10PD 6mo after surgery, the surgical success rate was 76%. The Grades I and Ⅱ binocular vision function improved 6mo after surgery(P<0.05), the distance stereopsis and the near stereopsis were not statistically significant(P>0.05). None of the patients developed A-V pattern, limitation of eye movement, restrictive strabismus, vertical strabismus, and rotated diplopia, some patients had transient horizontal diplopia, which disappeared within 2-3wk after surgery.
CONCLUSION:Slanted bilateral lateral rectus recession may successfully reduce the near exodeviations, the distance exodeviations and the near-distance deviations difference without obvious complications, proved to be a safe and effective procedure for the treatment of convergence insufficiency-type intermittent exotropia.
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