青少年间歇性外斜视手术前后立体视觉的临床观察

Changes in stereoscopic vision before and after intermittence exotropia surgery in adolescents

目的探讨青少年间歇性外斜视手术对患者立体视觉功能的影响情况。方法收集河南省开封市中心医院开封眼病医院门诊2010年1月至2012年9月收治的42例(42只眼)间歇性外斜视患者的临床资料。采用角膜映光法及三棱镜遮盖法测定眼位。视远、视近斜视角度以三棱镜记录。根据患者的斜视角度采用手术矫正的方法进行治疗。采用同视机检查患者的远立体视功能,评定并记录患者手术前后的双眼单视功能的有无或等级。患者手术前后双眼单视功能变化情况的比较采用Kruskal-Wallis H秩和检验。结果 42例(42只眼)患者中,术前无双眼单视功能的患者33例(33只眼),具有Ⅰ级双眼单视视功能的患者5例(5只眼),具有Ⅱ级双眼单视视功能的患者2例(2只眼),具有Ⅲ级双眼单视视功能的患者2例(2只眼);术后患者无双眼单视功能的患者23例(23只眼),具有Ⅰ级双眼单视功能的患者10例(10只眼);具有Ⅱ级双眼单视功能者5例(5只眼),具有Ⅲ级双眼单视功能的患者4例(4只眼)。结果显示,手术后具有双眼单视功能的患者例数增加,差异有统计学意义(Hc=-2.27,P<0.05)。结论对青少年间歇性外斜视患者采用手术矫正的方法治疗,术后部分患者的双眼单视功能能够得到一定程度的改善。

Objective To assess changes in the stereoscopic vision before and after intermittence exotropia surgery in adolescents.Methods Clinical records of 42 patients (42 eyes) who were diagnosised with intermittence exotropia and underwent surgical corrections in Henan Kaifeng Center hospital, Kaifeng Eye Hospital between January, 2010 and September, 2012 were retrieved.Data on changes in diagonal measurements,cover tests and stereoscopic vision examinations,and visual functions before and after surgery were analyzed the Kruskal-Wallis H rank test.Results Before surgery, 33 patients ( 33 eyes ) did not present with binocular single vision,5 presented (2 eyes) with grade I binocular single vision,2 presented (2 eyes) with grade II binocular single vision and 2 presented (2 eyes) with grade III binocular single vision.After operation,23 patients (2 eyes) showed no signs of binocular single vision,and 10,5 and 4 patients (10,5 and 4 eyes)presented with grade I,II and III binocular single vision respectively .The difference in visual function before and after surgery was statistically significant (Hc=-2.27,P <0.05). Conclusion Intermittence exotropia surgery may result in a certain degree of improvement in stereoscopic vision in adolescent patients.