知觉学习联合眼肌训练辅助手术治疗间歇性外斜视疗效及对患者视功能的影响

Curative Efficacy of Perceptual Learning Combined with Extraocular Muscles Training in Patients with Intermittent Exotropia Treated with Surgery and Its Effects on Visual Function

目的:探讨知觉学习联合眼肌训练辅助手术治疗间歇性外斜视疗效及对患者视功能的影响。方法:将80例符合纳入标准的间歇性外斜视患者随机分为对照组和观察组各40例,对照组患者采用手术治疗方式,观察组患者在对照组的基础上采用知觉学习联合眼肌训练辅助治疗。术后3个月,观察比较两组患者临床疗效、主观症状评分及视功能情况。并随访1年,比较两组患者眼位回退率。结果:观察组的治疗总有效率明显高于对照组(95.0%vs 80.0%)(P<0.05)。与对照组相比,观察组术后3个月主观症状评分显著降低(P<0.05)。视功能方面,观察组较对照组视功能I级例数明显减少,III级例数明显增多,差异具有统计学意义(P<0.05)。随访1年,观察组的眼位回退率为12.5%,明显低于对照组32.5%的眼位回退率(P<0.05)。结论:知觉学习联合眼肌训练辅助手术治疗间歇性外斜视可以显著提高临床疗效,改善主观症状及视功能,并且能够降低眼位回退率,临床上值得进一步研究。

Objective:To investigate the clinical effect of perceptual learning combined with extraocular muscles training in patients with intermittent exotropia treated with surgery and its effects on visual function.Methods:80 cases of patients with intermittent exotropia meeting the inclusion criteria were randomly divided into control group and the observation group,with 40 cases in each group.The control group was treated with surgery,while the observation group was given additional perceptual learning combined with extraocular muscles training after surgery.Then,the curative efficacy,score of subjective symptoms,visual function and recession rate of eye position after one year of follow-up were observed and compared between the two groups.Results:The total treatment efficiency in the observation group was significantly higher than that in the control group(95.0%vs 80.0%,P<0.05).Three months after surgery,the score of subjective symptoms in the observation group was statistically lower than that in the control group(P<0.05).In terms of visual function,the number of patients with visual function at stage I in the observation group was significantly decreased and that of patients with visual function at stage III was significantly increased,and the difference were statistically significant(P<0.05).After the 1-year follow-up,the recession rate of eye position in the observation group was 12.5%,which was statistically lower than 32.5%in the control group(P<0.05).Conclusion:Perceptual learning combined with extraocular muscles training in patients with intermittent exotropia treated with surgery can significantly increase curative efficacy,improve subjective symptoms and visual function,and reduce the recession rate of eye position,which is worthy of further study in clinic.