大角度外斜视两种手术矫正方法的对比分析

A comparative analysis of two operative methods on large-angle exotropia

目的将大角度外斜视外直肌超常量后退术和外直肌边缘楔形切开术进行比较，观察手术效果。方法两组共37例，手术前后均用角膜映光法和三棱镜遮盖法测定斜视度。A组（18例）行外直肌超常量后退联合内直肌截短术，B组（19例）行外直肌边缘楔形切开联合内直肌截短术。并能两组进行统计学分析。结果两组术前斜视度无统计学显著差异（P〉0．05），术后1-6个月复诊眼位的比较：A组16例≤±10^△，正位率88．89％，B组17例≤±10^△，正位率89．47％，两组正位率比较差异无统计学意义（x^2=0．03P〉0．05）。结论外直肌超常量后退和外直肌楔形切开术均可以有效地矫正大角度外斜视。

Objective To compare lateral rectus marginal myotomy with wedge excision combined with resection of medial rectus with over-routine-quantity recession of lateral rectus and resection of medial rectus in treatment of large angle exotropia and observe the clinical effect. Methods Thirty-seven cases of large angle exotropia were divided into 2 groups. Group A （18 cases） underwent over-routine-quantity recession of lateral rectus and resection of medial rectus, Group B （19 cases） underwent lateral rectus marginal myotomy with edge excision and resection of medial rectus. All patients were measured the deviation before and after operation by using Hirschberg test and prism cover test. The surgery was performed according to the amount of distance deviation. All the surgeries were performed by the same ophthalmologist. A successful alignment was defined as ＋ 10A or less in primary gaze while viewing distant and near targets. Results Before operation, the difference of strabismus angle between the two groups was no statistically significant （P 〉0.05）, the cosmetic success rate （± 10^△） was （88.89%） in group A and （89.47%） in group B. The difference between the two groups was not statistically significant （x^2 =0.03, P 〉0.05）. Conclusions There is no significant difference between over-routine-quantity recession of lateral rectus combined with resection of medial rectus and lateral rectus marginal myotomy with edge excision combined with resection of medial rectus for large angle exotropia.