成人共同性斜视术后近立体视功能恢复的影响因素

Factors affecting restoration of stereopsis following surgical correction of childhood concomitant constant strabismus in adults

目的探讨成人共同性恒定性斜视矫正术后近立体视功能恢复的影响因素。方法分析35例成人患者(21例外斜视,14例内斜视),术前近立体视功能≥400",术后3个月测近立体视功能等。对患者术后眼位、斜视类型及斜视病程等影响因素进行分析。结果 22例术后眼位≤±8~△患者,9例(40.9%)获得立体视,13例术后斜视度>±8~△患者无人获得立体视;术后眼位对立体视功能提高影响明显(P<0.05)。病程<10年患者术后立体视(60.0%)较病程≥10年患者术后立体视(20.0%)功能提高不明显(P>0.05)。21例外斜视患者术后立体视功能(38.1%)较14例内斜视患者术后(7.1%)明显提高(P<0.05)。结论成人共同性恒定性斜视术后立体视功能仍有可能恢复。术后立体视功能恢复主要取决于术后眼位及斜视类型。

Objective To evaluate the factors affecting the restoration of stereopsis following successful surgical correction of childhood concomitant constant strabismus in adults. Methods In a prospective study,35 consecutive patients（ 21 cases of exotropia and 14 cases of esotropia） with childhood-onset,comitant,horizontal,constant strabismus and near stereoacuity 〉400 seconds of arc in Titmus tests were enrolled. Eye positions were aligned by surgery. Postoperative stereopsis testing was performed using the Titmus test at 3 months. The course of strabismus,strabismus types and the recovery of visual function were analyzed. Results Postoperative alignment had influence on the restoration of stereopsis; 9patients（ 40. 9%） who had orthotropia gained stereopsis,whereas none of 13 patients who had horizontal heterotropia（ esotropia or exotropia） of equal or more than 8 PD gained stereopsis（ P〈0. 05）. Misalignment for 10 years or longer did not preclude the development of postoperative stereoacuity. There was a statistically insignificant increase in stereopsis in exotropes（ 38. 1%） compared with esotropes（ 7. 1%）（ P〈0. 05）. Conclusions The stereopsis of adult concomitant strabismus can be reestablished by surgery. Postoperative stereoacuity recovery mainly depends on the postoperative alignment and type of strabismus.