间歇性外斜视手术139例临床分析
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Clinical analysis of 139 cases after intermittent exotropia surgery
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    摘要:

    目的:探讨间歇性外斜视手术时机及治疗效果。

    方法:选取我院2014-05/2016-12期间收治入院的139例间歇性外斜视患儿进行前瞻性研究,根据年龄分3组:3~7岁58例(A组),8~12岁41例(B组),>12岁40例(C组),观察各组治疗效果。

    结果:三组术后3d,1、3、6mo手术正位情况差异有统计学意义(P<0.05); 术后不同时间点A组正位率均显著高于其余两组,组间差异有统计学意义(P<0.05); 且B组术后3d,1mo正位率显著高于C组,组间差异有统计学意义(P<0.05)。术后6mo各组立体视功能均较术前显著改善,组间差异有统计学意义(P<0.05); 且A组恢复立体视患者所占比例显著高于B组和C组,组间差异均有统计学意义(P<0.05)。术前各组斜视度数比较差异无统计学意义(P>0.05)。术后6mo各组斜视度数差异有统计学意义(P<0.05); 且A组斜视度数≤30所占比例高于其余两组(均P<0.05)。术后三组BCVA变化情况差异均有统计学意义(P<0.01); 且A组术后各时间点BCVA均优于其余两组,差异均有统计学意义(P<0.05)。各组患儿术后3mo与术后6mo组内BCVA差异均无统计学意义(P>0.05)。术后6mo随访三组眼位回退发生率差异有统计学意义(P<0.05),且A组低于B组和C组,B组较C组低,差异均有统计学意义(P<0.05)。

    结论:间歇性外斜视应尽早根据斜视分型选择适当术式,促进术后眼位及视功能恢复,继而提高视力,避免眼位回退。

    Abstract:

    AIM:To investigate the operation opportunity and therapeutic effect of intermittent exotropia.

    METHODS: A prospective study of 139 patients with intermittent exotropia admitted to our hospital from May 2014 to December 2016 was conducted. Patients were divided into three groups according to their ages: Group A with 58 cases aged between 3 and 7 years old, Group B with 41 cases aged from 8 to 12 years old and Group C with 40 cases aged more than 12 years old. The therapeutic effect of each group was observed.

    RESULTS: The postoperative orthographic rate between the three groups at 3d, 1, 3 and 6mo postoperatively had statistical differences(P<0.05). The postoperative orthographic rate of Group A was significantly higher than that of the other two groups at different time points(P<0.05). The postoperative orthographic rate of of Group B at 3d and 1mo after operation was significantly higher than that of Group C(P<0.05). After operation, the stereoscopic function of each group at 6mo postoperatively was significantly improved, and the statistical difference between the groups was significant(P<0.05). The proportion of patients with stereopsis recovered in Group A was significantly higher than those in Groups B and C(P<0.05). There was no significant difference in the preoperative strabismus degree between either two groups(P>0.05), while the degree of strabismus in each group after 6mo was significantly different(P<0.05). And the proportion of strabismus ≤30 in Group A was higher than the other two groups(P<0.05). The changes of BCVA among the three groups after operation had significant differences(P<0.01). The BCVA of Group A was better than the other two groups at 3d, 1,3 and 6mo after operation(P<0.05). There were no significant differences between BCVA of 3mo and 6mo after operation in each group(P>0.05). There was a statistically significant difference in the incidence of ocular regression rate in three groups during the 6mo follow-up(P<0.05); that of Group A was lower than Group B and Group C(P<0.05)and Group B were lower than Group C, and the statistical difference between groups was significant(P<0.05).

    CONCLUSION: The surgical type of the intermittent exotropia should be based on the classification of strabismus, which can promote postoperative recovery of the eye position and visual function, improve visual acuity, and then avoid ocular regresses.

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罗海霞,贺蔷薇,李克芳,等.间歇性外斜视手术139例临床分析.国际眼科杂志, 2018,18(9):1673-1677.

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  • 收稿日期:2018-02-26
  • 最后修改日期:2018-08-02
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  • 在线发布日期: 2018-08-17
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