融合功能训练在大龄人群斜视矫正术后疗效的评价

Evaluation of the effect of fusion training on strabismus correction in the elderly

目的分析融合功能训练在大龄人群行斜视矫正术后建立双眼三级视功能及巩固术后效果的可能性。方法回顾性研究2008年10月—2016年12月在广州爱尔眼科医院被诊断为共同性斜视并进行手术矫正的患者174例,术后进行融合功能训练。根据术前诊断斜视的类型分成共同性内斜视组、共同性外斜视组、间歇性外斜视组,根据两眼最佳矫正视力差别分为>2行、≤2行组,训练时对单眼抑制及交叉抑制者先采用脱抑制训练再扩大融合功能训练,具有较小融合范围的矫正术后的患者直接从扩大融合功能开始训练,对比观察斜视手术矫正前和矫正后进行融合训练后融合功能及双眼视情况。结果斜视矫正术后128例建立了正常的融合范围,随访1年斜视无复发,无视疲劳症状发生。其中共同性外斜视组、共同性内斜视组、间歇性外斜视组进行训练后治疗的有效率分别为32.35%、28.57%、100%,两眼最佳矫正视力相差>2行和≤2行的有效率分别为11.54%、100%。结论大龄斜视患者尤其是间歇性外斜视或双眼最佳矫正视力相差在2行以内的患者,经过融合训练均获得良好的双眼视,视疲劳得到改善,斜视手术效果得到巩固。

Objective To analyze the possibility of fusion function training to establish binocular tertiary vision function and consolidate the effect of postoperative strabismus correction in elderly people.Methods Conduct a retrospective study about 174 patients who were diagnosed with common strabismus and had corrective surgery at Guangzhou Aier Eye Hospital from October 2008 to December 2016,and those patients was performed after the fusion function training.According to the type of preoperative diagnosis of strabismus,they were divided into common esotropia group,common exotropia group,intermittent exotropia group.According to the difference of the best corrected visual acuity between the two eyes,they were divided into>2 lines group and≤2 lines group.Monocular-suppression and cross-suppression patients firstly used de-inhibition training and then expand the fusion-range training.Patients with a smaller fusion range started training directly by expanding the fusion function.We compared and observed the fusion function and binocular condition between before and after strabismus surgery.Results The normal fusion range was established in 128 cases after strabismus correction,and there was no recurrence of strabismus and visual fatigue symptoms after 1 year of follow-up.Among them,the effective treatment rates of the common exotropia group,the common esotropia group,and the intermittent exotropia group after training are 32.35%,28.57%,and 100%,respectively.The two groups which are divided into>2 lines group and≤2 lines group are 11.54%and 100%,respectively.Conclusion Elderly patients with strabismus,especially those with intermittent exotropia or within two lines of best corrected visual acuity,have achieved good binocular vision after fusion training,have been improved visual fatigue,and the effect of strabismus surgery is consolidated.