双眼视觉训练对间歇性外斜视儿童术后双眼视功能重建的观察

Observation on postoperative binocular visual function reconstruction in intermittent exotropia children with binocular visual training

目的:分析双眼视觉训练对间歇性外斜视儿童术后双眼视功能重建效果的影响。方法:回顾性分析2013-04/2016-04我院收治的间歇性外斜视患儿108例,其中45例术后未予以双眼视觉功能训练作为对照组,63例术后采用TSJ-Ⅳ型同视机训练软件进行双眼视觉训练作为观察组。观察两组术后双眼视觉功能重建及眼位回退情况。结果:术前两组患儿双眼视功能、斜视度数等基线资料差异均无统计学意义(P>0.05)。术后3mo,观察组三级视功能显著较术前改善,且观察组同时视、视觉融合及立体视患儿所占比例均显著高于对照组,差异均有统计学意义(P<0.05);观察组黄斑立体视及黄斑中心凹立体视患儿所占比例显著高于对照组,且观察组无立体视患儿所占比例明显低于对照组,差异均有统计学意义(P<0.05)。术后3mo,观察组斜视度数≤30~△患儿所占比例显著高于对照组,差异有统计学意义(P<0.05)。术后1a回访,观察组眼位回退率明显较对照组低,差异有统计学意义(P<0.05)。结论:间歇性外斜视术后配合同视机双眼视觉训练可促进双眼视觉功能重建,改善斜视度数,同时还可避免术后眼位回退情况。

AIM： To investigate postoperative binocular visual function reconstruction in intermittent exotropia children with binocular visual training. METHODS： The clinical data of 108 cases of intermittent exotropia children admitted to our hospital from April 2013 to April 2016 were retrospectively analyzed. Among them,45 cases with binocular visual function training were included in the control group; the other 63 cases with TSJ-IV synoptophore training software for binocular vision training were included in the observation group. The binocular visual function reconstruction and eye position regression of the two groups were observed.RESULTS： Baseline data of binocular visual function and strabismus in two groups had no significant difference before surgery（ P〈0. 05）. At 3 mo after operation,the visual function of grade three in the observation group was significantly improved,and the proportion of simultaneous vision, visual fusion and stereopsis in the observation group were significantly higher than those in the control group（ P〈0. 05）. The proportion of patients with macular stereopsis and foveal stereopsis in the observation group was significantly higher than that in the control group,and the proportion of patients without stereopsis in the observation group was significantly lower than that in the control group,and the difference was statistically significant between groups（ P〈0. 05）. At 3 mo after operation,the proportion of strabismus ≤ 30^△ in the observation group was significantly higher than that in the control group,with statistical significance（ P〈0. 05）. In addition,the eye position regression rate of the observation group was significantly lower than that of the control group in the postoperative 1 a follow-up,and there was significant difference between the two groups（ P〈0. 05）.CONCLUSION： The children with intermittent exotropia taking postoperative synoptophore training can promote binocular visual function reconstruction,ameliorate the degree of strabismus, and avoid postoperative eye recession.