不同术式治疗集合不足型间歇性外斜视患儿的效果及对视觉功能的影响

Effect of different surgical treatments on children with intermittent exotropia with insufficient convergence and its influence on visual function

目的探讨不同术式治疗集合不足型间歇性外斜视患儿的效果及对视觉功能的影响。方法回顾性分析2018年2月至2020年2月收治的102例集合不足型间歇性外斜视患儿的临床资料,根据手术方式将患儿分为A组(31例,双眼内直肌缩短术)、B组(33例,双眼外直肌后徙术)及C组(38例,单眼内直肌缩短术+外直肌后徙术)。比较三组的治疗效果。结果手术后6个月,三组视远、视近的斜视度均较手术前降低,且B、C组视远、视近的斜视度均低于A组(P<0.05)。三组的矫正效果及优良率比较,差异均具有统计学意义(P<0.05);且B、C组的矫正优良率均高于A组(P<0.01)。三组术后6个月内并发症总发生率比较,差异无统计学意义(P>0.05)。结论双眼外直肌后徙术、单眼内直肌缩短术+外直肌后徙术治疗集合不足型间歇性外斜视的效果优于双眼内直肌缩短术,且安全可靠,值得临床推广和应用。

Objective To explore the effect of different surgical treatments on children with intermittent exotropia with insufficient convergence and its influence on visual function.Methods The clinical data of 102 children with intermittent exotropia with insufficient convergence admitted from February 2018 to February 2020 were retrospectively analyzed,and the children were divided into group A(31 cases,bilateral medial rectus shortening),group B(33 cases,bilateral lateral rectus recession)and group C(38 cases,monocular medial rectus shortening+lateral rectus recession)according to the operation method.The therapeutic effects of the three groups were compared.Results At 6 months after operation,the strabismus degrees of distant and near vision in the three groups were lower than those before operation,and the strabismus degrees of distant and near vision in the group B and the group C were lower than those in the group A(P<0.05).There were significant differences in the correction effect and excellent and good rate among the three groups(P<0.05);the excellent and good rate of correction in the group B and the group C were higher than that in the group A(P<0.01).There was no significant difference in the total incidence of complications among the three groups within 6 months after operation(P>0.05).Conclusion Bilateral lateral rectus recession,monocular medial rectus shortening+lateral rectus recession have better effect than bilateral medial rectus shortening in the treatment of intermittent exotropia with insufficient convergence,and those are safe and reliable,which are worthy of clinical promotion and application.