论著

基于Base-out恢复点为目标手术量的急性共同性内斜视手术效果

Surgical effect of acute concomitant esotropia based on base-out recovery point as target operation volume

:192-199
 
目的:探讨以Base-out恢复点为目标手术量的急性共同性内斜视(acute acquired comitant esotropia,AACE)的治疗效果。方法:随诊以Base-out恢复点为目标手术量、且术后随访时间超过4个月的AACE患者,分析术前及末次随诊时斜视度、双眼视功能参数及术后立体视恢复的影响因素。结果:将43例患者纳入研究,其中男27例(63%),女16例(37%),手术年龄9~53(23.7±11.4)岁,术前斜视持续时间3个月~11年(24.8±24.5个月),术后随访4~62(15.8±14.5)个月。术前Base-out恢复点比斜视度更大[远距差值(9.3±6.9) PD,P<0.001;近距差值(11.4±6.7) PD,P<0.001];术前视远和视近斜视度分别为(38.4±13.2) PD和(37.6±13.7) PD,末次随诊时视远和视近斜视度分别为(0.74±2.4) PD和(0.70±2.4) PD(均P<0.001),38例(88%)患者无眼位偏斜,5例(12%)有轻微内隐斜视。末次随诊时视远和视近立体视锐度显著改善(P<0.001),末次立体视功能与术前近距立体视水平和术前斜视持续时间相关。结论:以Base-out恢复点为目标手术量的AACE手术能取得较好的矫正效果,未见眼位过矫者;术后立体视恢复与术前近距立体视和术前斜视持续时间相关,提示适当早期手术可能有助于术后立体视功能的恢复。
Objective: To evaluate the effect of using the amount of base-out (BO) recovery point as the surgical target for acute acquired comitant esotropia (AACE). Methods: Patients with AACE underwent surgery based on the target angle of the base-out recovery point and were followed up at least 4 months. The deviation, binocular functions before and after the surgery were analyzed and the factors related the post-operative stereopsis were evaluated. Results: Totally 43 patients were included in the study, including 27 males (63%) and 16 females (37%), aged from 9 to 53 years (23.7±11.4 years), duration of preoperative strabismus ranged from 3 months to 11 years (24.8±24.5 months), and postoperative follow-up ranged from 4 to 62 (15.8±14.5 months). Both distant and near pre-operative Base-out recovery point were larger than the angle of esotropia [(9.3±6.9) PD for distant; (11.4±6.7) PD for near, both P<0.001]. The pre-operative esotropia for distant and near viewing were (38.4±13.2) PD and (37.6±13.7) PD respectively and reduced to (0.74±2.4) PD and (0.70±2.4) PD at the last visit time (P<0.001). Thirty-eight cases were orthosia without any phoria and five cases still had some esophoria or minimal esotropia at the last visit. The stereoacuity improved significantly after the surgery. The post-operative stereopsis significantly correlated with the pre-operative stereopsis and the duration from onset of esotropia to the time of surgery. Conclusion: The acute acquired comitant esotropia can be corrected with strabismus surgery based on the target angle of base-out recovery point. The post-operative stereopsis correlated with the pre-operative stereo function and the time of esotropia lasting. It suggested the earlier esotropia was corrected the better the stereopsis recovered.
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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