双眼视觉在间歇性外斜视手术前后变化及手术效果相关研究
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Comparison and evaluation of the surgical effect and binocular vision change before and after surgery for intermittent exotropia
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    摘要:

    目的:观察间歇性外斜视术前双眼视功能状态和术后双眼视功能的重建与恢复,分析双眼视功能对术后眼位正位的影响。

    方法:收集我院2011-01/2014-01收治的47例基本型间歇性外斜视患者的临床资料,记录术前术后近立体视、双眼同时视、融合功能及远立体视功能的变化,分析间歇性外斜视患者术前双眼视功能的缺陷和术后的恢复重建,并对两者进行对比,观察双眼视功能的存在、恢复和重建对术后维护眼位正位的作用。

    结果:间歇性外斜视患者术前双眼视功能不同程度受到破坏,远立体视破坏最早、最多; 术后各项功能均得到明显的恢复和重建,与术前相比有显著统计学差异(P<0.01)。术前存在或部分存在双眼视功能的患者相比其丧失者术后正位率明显高,有显著统计学差异(P<0.01)。术后双眼视功能的恢复和重建对维持眼位正位很重要。

    结论:间歇性外斜视对远立体视功能破坏发生最早,术后双眼视功能均有明显的恢复和重建,术前相对好的双眼视功能可使间歇性外斜视患者增加术后眼位正位率,甚至达到功能性治愈。选择以远立体视破坏为手术时机可提高手术成功率,降低复发率。

    Abstract:

    AIM: To investigate the preoperative binocular visual function of intermittent exotropia and the rebuilding and recovery of the postoperative binocular visual function, and analyze the effect of binocular visual function on orthophoria after surgery.

    METHODS: From January 2011 to January 2014, 47 basic intermittent exotropia patients caming for treatment were collected in the clinical data. The changes in their near stereopsis, binocular visual function, binocular fusion and distance stereopsis after operations were recorded in the form of data. The preoperative binocular vision and the postoperative rebuilding were analyzed and contrasted with each other. In addition, the effect on the postoperative maintaining of orthophoria due to the existence, recovery and rebuilding of binocular visual function were observed.

    RESULTS: Intermittent exotropia patients got damage in different levels on their binocular visual functions, especially on distance stereopsis, which was the heaviest and earliest. After the operation, all functions were obviously recovered and reconstructed and the improvements were statistically significant compared against those before the operation(P<0.01). Patients having binocular visual function or part of it before the operation had a higher ratio of orthophoria compared against the patients who had lost binocular visual function before the operation and the difference was statistically significant(P<0.01). The recovery and reconstruction of the postoperative binocular visual function played an important role in maintaining the orthophoria.

    CONCLUSION: The intermittent exotropia cause damage to the stereopsis which happened the earliest. Obvious recovery and reconstruction of binocular visual function can be observed after the surgery. A relatively good preoperative binocular visual function may lead to the increase in the ratio of orthophoria or cure the intermittent exotropia. Performing an operation when distance stereopsis is damaged can increase the success rate for the surgery and reduce the recurrence rate.

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华文娟,顾永辉,徐丹丹.双眼视觉在间歇性外斜视手术前后变化及手术效果相关研究.国际眼科杂志, 2015,15(4):681-683.

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  • 收稿日期:2014-12-27
  • 最后修改日期:2015-03-25
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  • 在线发布日期: 2015-04-08
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