手术治疗V型斜视和术后立体视重建

Surgical treatment of V-strabismus and re-establishmentof stereo vision after operation

目的:探讨不同手术方式治疗V型斜视的手术效果,观察手术前后立体视功能的变化。方法:根据52例V型斜视患者向上和向下25°注视时的斜视度变化及下斜肌功能,分别采用水平直肌后徙和/或缩短+下斜肌减弱术、水平直肌后徙和/或缩短+垂直移位术及水平直肌后徙和/或缩短并垂直移位+下斜肌减弱术矫正V型斜视。观察三种手术方式的治疗效果。结果:三组患者上下斜视角差分别由术前21.10△±3.38△、42.00△±7.72△、23.85△±6.50△变为术后7.20△±3.10△、7.13△±2.96△、7.02△±2.89△,V型斜视消失。用同视机、Worth四点灯、Titmus立体图检查,V鄄内斜、V鄄外斜术前、术后融合功能具有统计学意义(P<0.05雪。结论:根据向上和向下25°注视时的斜视度变化及下斜肌功能,采用三种不同手术方式治疗V型斜视有效可靠。

Objective: To explore the surgical treatment of V pattern strabismus and to observe their changes of stereo vision before and after operation. Methods: Based on the oblique muscle functions and the differences of deviation angle of up and down gazes, 52 patients were divided into three groups and treated with three surgical methods, namely, vertical transposition of horizontal recti, inferior oblique weakness without vertical transposition of horizontal recti, and vertical transposition of horizontal recti combined with inferior oblique weakness. The surgical effects of three procedures and visual function were observed before and after operation. Results: The differences of deviation angle of up gaze and down gaze were 21.10△±3.38△, 42.00△±7.72△, and 23.85△±6.50△ before operation, and 7.20△±3.10△, 7.13△±2.96△, and 7.02△±2.89△ after operation. Fusion functions had significant difference before and after operation. Conclusion: All the three surgical procedures for V pattern strabismus were effective.