继发性内斜视手术前后双眼视觉及手术时机的研究

Study on the binocular vision and surgery time for secondary esotropia

目的分析继发性内斜视手术方式及二次手术前、后双眼视觉。方法对59例均有外斜视手术矫正病史的继发性内斜视进行手术治疗并观察两次手术术前、术后双眼视觉的变化。结果对有外转受限和侧方非共同性的患者,采用外直肌复位或缩短复位,不足联合内直肌后徙术,对无外转受限和侧方非共同性的患者,采用内直肌后徙,不足联合外直肌复位或缩短复位术。间歇性外斜视过矫所致的继发性内斜视对双眼视觉损害更大,手术前、后双眼视觉对比有统计学意义。结论外直肌复位联合内直肌后徙是治疗继发性内斜视的有效方式,尽早手术治疗,有利于双眼单视功能的恢复。

Objective To observe and analyse the surgical methods and the binocular vision of pre operation and post opera- tion in secondary esotropia. Methods fifty nine cases of secondary esotropia which had clinical history of esotropia surgery under- went surgery treatment and the binocular vision of preoperation and postoperation were observed. Results Lateral rectus muscles reposition or shortening to repostion was performed in those who have restriction of abversion and lateral nonconcomitant esotropi- a,and combine medial rectus muscle recession were performed in insufficient cases,medial rectus recession were performed in those who haven＇t restriction of abversion and combined lateral rectus reposition or shorten to reposition in those insufficient. There was statistical difference in binocular vision between preoperation and postoperation. Conclusion lateral rectus muscles reposition com- bined medial rectus muscles recession is an efficient way to treat secondary esotropia, early treatment is beneficial to recover the function of binocular vision.