间歇性外斜视患儿术后视功能及多焦视觉诱发电位的变化

Study on the changes of visual function and multifocal visual evoked potential in children with strabismus after intermittent exotropia operation

目的:探讨间歇性外斜视术对斜视患儿视功能及多焦视觉诱发电位的影响。方法:选取2014-01/2017-12期间就诊的91例间歇性外斜视患儿为研究对象,所有患儿均手术治疗。观察患儿手术前后视功能变化情况,检测其手术前后多焦视觉诱发电位水平。结果:术后1wk总有效率为88%,术后6mo总有效率为86%;术前患儿平均斜视度为-38.12△,术后为-5.8△。术后6mo同时视、融合、远立体视的患儿例数较术前显著增加(P<0.01);术后6mo患儿正位率为68%;术前三级视功能都存在或只存在其一二者术后绝大多数为正位,相比其丧失者术后正位率明显较高(P<0.05)。自术前至术后6mo患儿第四环、第六环的特征峰振幅反应密度与鼻侧、颞侧视网膜潜伏期水平均显著升高,下方视网膜潜伏期水平显著下降(P<0.05)。结论:间歇性外斜视术可有效提高患儿视功能,促进患儿眼位的恢复,且术后患儿多焦视觉诱发电位水平也得到一定改善,临床效果突出。

AIM:To investigate the changes of visual function and multifocal visual evoked potential in children with strabismus after intermittent exotropia operation.METHODS:Totally 91 children with intermittent exotropia from January 2014 to December 2017 were enrolled in the study.All children were treated with surgery.The changes of visual function before and after operation were observed,and the level of multifocal visual evoked potential before and after operation were detected.RESULTS:The total effective rate was 88%at one week after operation,86%at 6mo after operation,the mean preoperative strabismus was-38.12△,and the mean postoperative strabismus was-5.8△.At 6mo after operation,the number of children with simultaneous vision,fusion and distant stereopsis decreased significantly as compared with that before operation(P<0.01).The orthopedic rate was 68%at 6mo after operation,and the majority of the patients with all or only one or two grade visual function before the operation were positive,which was significantly higher than that of the patients who lost it after operation(P<0.05).From before operation to 6mo after operation,the amplitude response density of the characteristic peak and the latency of the nasal and temporal retinas in the fourth and sixth rings of the children were significantly increased,while the latent period of the inferior retina was significantly decreased(P<0.05).CONCLUSION:Intermittent exotropia operation can effectively improve the visual function of children and promote the recovery of eye position in children,and the level of multifocal visual evoked potential in children after operation is also improved to some extent.The clinical effect is outstanding,and it is worth popularizing and applying.