手术时机对儿童先天性内斜视治疗效果的影响

Effect of operation time on the treatment of children with congenital internal strabismus

目的 探讨先天性内斜视患儿手术时机对患儿斜视矫正效果的影响.方法 回顾性分析2012年3月至2015年3月间在本院接受手术的146例先天性内斜视患儿临床资料,比较≤2岁组和＞2岁组患儿在手术后1周和6个月时的眼球正位率、欠矫率和过矫率.结果 146例患儿中88例斜视度≥40PD（瞳距）,占60.3％,合并弱视38例（26.0％）,合并眼球震颤12例（8.2％）,合并下斜肌亢进30例（20.5％）,合并分离性垂直偏斜（DVD）6例（4.1％）,＞2岁和≤2岁组患儿术后1周和6个月时眼球正位率、欠矫率和过矫率差异均无统计学意义（P＞0.05）.结论 先天性内斜视宜早期接受手术,2岁前手术可使患儿更好的形成和恢复双眼视功能,斜视角度大者更应尽早手术.

Objective To investigate the surgery opportunity choice of congenital esotropia.Methods A retrospective research was taken using the clinical data and the results of the treatment of 146 inpatients with congenital esotropia in our department from Mar 2012 to Mar 2015.The correction rate,lackingcorrection rate,and over-correction rate were compared between early surgery group and late surgery group on time of 1 week after surgery and 6 months after surgery,respectively.Results In all the 146 patients,88 （60.3%） had an esotropia deviation greater than or equal to 40 pupil distance （PD）,38 （26.0%） combined with amblyopia,12 （8.2%） combined with nystagmus,30 （20.5%） combined with inferior oblique muscle overaction,6 （4.1%） combined with dissociated vertical divergence （DVD）.There was no significant difference between early surgery group and late surgery group on correction rate,lacking-correction rate,and over-correction rate on the time of 1 week after surgery and 6 months after surgery,respectively.Conclusions Congenital strabismus should take surgery at the early-stage,especially for those have large angles.It is better to be operated before 2-year old for a better formation and recovery of binocular visual function.