连续性外斜视的手术治疗

Studing the reason and the treatment of consecutive extropia

目的研究连续性外斜视的发病因素及手术治疗。方法对在我市眼科医院眼肌科住院的28例连续性外斜视的病人施行手术治疗，并就其发病因素及手术疗效进行了回顾性的研究。结果内斜视的发病年龄、伴垂直性眼位偏斜、弱视、调节性集合功能减弱和双眼视功能不良等是形成连续性外斜视的重要因素。外斜视矫正的效果与术中手术量大小、术前斜视角、手术方式、术中眼位矫正情况等因素有关。术后双眼视功能较术前明显好转。结论1．内斜视术前应充分考虑到眼位不稳因素，并积极治疗。2．内斜术后应该进行长期的随访，并根据眼位变化情况及时调整眼镜度数。3．单纯内直肌复位眼位回退明显，外直肌后徙联合后徙的内直肌前移是治疗连续性外斜视的有效方法。4．术中5～10PD小度数过矫可提高术后的正位率。5．手术矫正外斜视有利于双眼视恢复。

Objective To review the reason and the techniques of surgical treatment of consecutive extropia. Methods We performed a retrospective chart review of 28 patients who underwent surgery for consecutive exotropia in a pediatric ophthalmology practice between 1998 to 2004. A retrospective study on 28 patients who underwent surgery for XTc was carried out in our department. Result The presence of the age of the estropia is very early, the dissociated vertical deviation,the amblyopia and the function of the accommodative-convergence/ accommodative（AC/A） is week were found to be the most common factors in the development of a XTc in our study. Xtc is also relation to the surgery result, the diplopia angle of thepresurgery and the eye position in surgery. Conclusions 1. We should follow-up such cases that be given long-term. 2.Lateral rectus recession with advancement of the previously recessed medial rectus is an effective treatment for con- secutive exotropia. 3.A suitable ocular alignment immextiately after surgery for consecutive exotropia is a small- angle esotropia of 5 to 10 PD.