压贴三棱镜联合手术矫正共同性内斜视疗效观察

Observation of Curative Effect Pressing Triple Prism Combined with Surgery on Concomitant Esotropia

目的:探讨压贴三棱镜联合手术治疗共同性内斜视矫正的效果。方法:回顾性分析笔者医院2018年5月-2020年6月60例共同性内斜视患儿临床资料,将给予压贴三棱镜并接受斜视矫正手术治疗的患儿纳入A组,将采用单纯手术治疗的患儿29例纳入B组,比较两组矫正效果、双眼视功能以及眼球屈光度。结果:A组术后3个月正位率93.55%高于B组68.97%(P<0.05);两组治疗后同时视功能比较,差异无统计学意义(P>0.05);A组术后1个月、术后3个月有融合功能比例分别为64.52%、74.19%高于B组37.93%、48.28%(P<0.05);A组术后7 d、术后1个月、术后3个月平均融合范围大于B组(P<0.05);A组术后1个月、术后3个月近立体视功能优于B组(P<0.05);两组治疗后柱镜屈光度、球镜屈光度、散光值、散光轴位比较,差异无统计学意义(P>0.05)。结论:共同性内斜视矫正术前联合使用压贴三棱镜提高了术后正位率,增强了术后融合功能和立体视功能恢复效果,不影响眼球屈光度。

Objective To explore the correction effect of pressing triple prism combined with surgery on concomitant esotropia.Methods A retrospective analysis was performed on the clinical data of 60 children with concomitant esotropia in the author's hospital between May 2018 and June 2020.Children who were treated with A pressed prism and underwent corrective surgery for strabismus were included in group A,while other 29 children only treated with surgery were included in group B.The correction effect,binocular vision function and eyeball diopter were compared between the two groups.Results The orthophoria rate in group A was higher than that in group B at 3 months after surgery(93.55%vs 72.41%)(P<0.05).After treatment,difference in visual function between the two groups was not statistically significant(P>0.05).At 1 month and 3 months after surgery,proportions of fusion function in group Awere 64.52%and 74.19%,higher than 37.93%and 48.28%in group B(P<0.05).At 7 d,1 month and 3 months after surgery,average fusion range in group A was larger than that in group B(P<0.05).At 1 month and 3 months after surgery,stereopsis function in group A was better than that in group B(P<0.05).After treatment,difference in cylinderdiopter,spherical diopter,astigmatism value and astigmatism axis between the two groups was not statistically significant(P>0.05).Conclusion The pressing triple prism combined with correction surgery for concomitant esotropia can improvepostoperative orthophoria rate,enhance postoperative recovery effects offusion function and stereopsis function,without affecting eyeball diopter.