54例V型斜视手术治疗的临床疗效观察

OPERATION ON 54 CASES OF TYPE V STRABISMUS

目的探讨Ⅴ型斜视手术治疗的临床效果。方法对54例Ⅴ型斜视全部采用了同视机三级视功能检查，三棱镜遮盖法分别测定原在位、向上注视25°、向下注视25°的斜视度，检查6个诊断眼位的双眼平行运动，分别行双眼水平肌后徙十移位术，双眼水平肌后徙＋下斜肌后徙减弱术。结果术后随访4～14个月，平均9个月，54例Ⅴ型斜视中，46例术后效果满意，其中26例双眼上、中、下注视时正位，20例原在位及向下注视时正位。双眼单视功能术后4例产生同时视，15例获得融合功能，29例产生立体视，3例无同时视，3例放弃视功能训练。结论Ⅴ型斜视根据不同的类型，选择不同的手术方式，手术后可获得正常的眼位和双眼视功能。

Objective To explore the curative effects of operation on Type Ⅴ strabismus. Methods Tertiary Visual functions of 54 cases of strabismus were determined by synoptophore. The degrees of squint in the primary position, the position of upward stare of 25o , the position of downward stare of 25° were detected and the binocular paraller movements of diagnosing eye positions were also detected through prism optometer. Then,operations like binocular parallel muscle backward thansfer plus transposition or binocular parallel musle backward transfer plus inferior oblique tousle backward tranfer weakening surgery were performed. Results According to the 4-14- month follow-up surveys, 46 cases got satisfactory results, and among them, 26 cases recoverel with the right binocular visual position when they stared upward, forward and downward, and 20 cases got the right visual position when they stared in the primary position and stared downward. After the operations concerning the binocular monocular visual functions, 4 cases could produce synchronism, 15 cases got integrative visual functions, 29 cases produced stereopsis and only 3 cases gave up visual training. Conclusion Right visual position and good binocular visual functions can be got if appropriate operations are chosen according to different types of strabismus.