眼外直肌后徙术联合内直肌缩短术与双眼外直肌后徙术治疗儿童间歇性外斜视的对比分析

Comparative analysis of unilateral lateral rectus recession-medial rectus recession and bilateral lateral recession in treatment of children with intermittent exotropia

目的对比分析眼外直肌后徙联合内直肌缩短术与双眼外直肌后徙术治疗儿童间歇性外斜视的疗效,旨在为提高临床治疗效率提供理论依据。方法选择2014年1月-2015年1月在我院接受治疗的儿童间歇性外斜视患者280例,随机分为研究组和对照组;对照组应用双眼外直肌后徙术治疗,研究组应用眼外直肌后徙联合内直肌缩短术治疗,对比两组患者术后6个月眼位矫正效果,统计手术前后视远度、视近度、平均斜视度,并对比分析术后立体视恢复率、融合功能恢复率、并发症发生率。结果研究组患者正位率为87.14%,对照组为74.29%,研究组显著高于对照组,差异有统计学意义（P〈0.05）;研究组患者术后视远度为（5.13±0.34）θ、视近度为（5.58±0.47）θ、平均斜视度为（5.36±0.29）θ,均显著优于对照组,差异有统计学意义（P〈0.05）;研究组患者术后立体视恢复率为72.14%、融合功能恢复率为60.71%,均显著高于对照组,差异有统计学意义（P〈0.05）,但研究组患者并发症率为10.71%,显著高于对照组（4.29%）。结论眼外直肌后徙联合内直肌缩短术治疗儿童间歇性外斜视在正位率、融合功能及立体视功能恢复方面显著优于双眼外直肌后徙术。

Objective To analyze the unilateral lateral rectus recession-medial rectus recession and bilateral lateral recession in treatment of intermittent exotropia effect, aims to provide a theoretical basis for the im provement of the treatment efficiency. Methods Selected from Jan 2014 to Jan 2015 in our hospital 280 cases children with intermittent exotropia, and were randomly divided into study group and the control group on average, the control group were treated by bilateral lateral recession, study group of patients with unilateral lateral rectus recession-medial rectus recession,compared two groups of patients after 6 months of eye position correction effect, the statistics before and after surgery in patients with distant and near vision degrees, average the strabismus degree, and the two groups of patients with stereopsis recovery rate, stereoscopic fusion recovery rate, complications rate were compared. Results Study patients orthophoric rate was 87.14%, the control group was 74.29%, the study group was significantly higher than the control group, and the difference was statistically significant（ P〈0.05）; study patients after surgery distant vision degrees was（5.13±0.34） θ, near vision degrees was（5.58±0.47） θ, the average degree of strabismus was（5.36±0.29） θ, were significantly better than the control group; study group postoperative stereopsis recovery rate was 72.14%, stereoscopic fu sion recovery rate was 60.71%, and were significantly higher, and the difference was statistically significant（P〈0.05）,but the study group patients complication rate was 10.71%, significantly higher than the control group（4.29%）. Conclusion Unilateral lateral rectus recession-medial rectus recession for the treatment of children with intermittent exotropia in a orthophoric rate, fusion function and stereo visual function recovery was significantly better than that of the bilateral external lateral recession operation.