知觉性外斜视手术疗效分析

Analysis of the surgical efficacy for sensory exotropia

目的分析知觉性外斜视手术的远期疗效。方法回顾性分析2011年1月至2015年12月33例知觉性外斜视的临床资料。33例随机分为术毕过矫组（过矫5^Δ～10^Δ）15例和术毕正位组18例。结果随访12～52个月。末次随访，术后正位26例（78．79％），欠矫7例（21．21％），无过矫者。术毕过矫组术后正位率高于术毕正位组，小斜视度者术后正位率高于大斜视度者，差异均有统计学意义（P〈0．05）。术前斜视眼视力较好者与视力较差者的术后正位率相比，差异无统计学意义（P〉0．05）。结论知觉性外斜视行手术矫正能有效改善外观，满意度高。术毕轻度过矫者术后远期眼位好，术前斜视度小者术后远期眼位好，斜视眼视力的好坏对术后眼位影响不明显。

Objective To analyse the long-term efficacy of strabotomy surgery for sensory exotropia. Methods Thirty-three cases of sensory exotropia from Jan. 2011 to Dec. 2015 who underwent monocular strabismus surgery were retrospectively analyzed. All cases were randomly divided into two groups： over corrected group postoperative, 5 ^Δ-10^Δ esotropia after surgery, 15 cases, and orthophoria group postoperative, 18 cases. Results The follow-up time was 12-52 months. At last follow-up, orthophoria occurred in 26 cases（78.79% ）, under-corrected in 7 cases （21.21%）, and none was over-corrected. The postoperative orthophoria rate of over corrected group was higher than that of orthophoria group. The difference was statistically significant （ P 〈 0.05 ）. The postoperative orthophoria rate of patients with smaller-angle strabismus was higher than that of patients with larger-angle strabismus. The difference was statistically significant （ P 〈 0.05 ）. The postoperative orthophoria rate of patients with better vision was higher than that with poor vision. The difference was not statistically significant （P 〉 0.05）. Conclusion Strabismus surgery for the treatment of sensory exotropia is a effective method with high satisfaetion. The patients with immediate mild over correction after surgery have good postoperative eye position. The patients with preoperative smaller-angle strabismus have good postoperative eye position. BCVA of squinting eye has no effect on postoperative eye position.