视感知觉训练对间歇外斜视患儿术后视功能恢复的影响

The effect of visual perception training on postoperative visual function recovery in children with intermittent exotropia

目的:探讨间歇性外斜视患儿术后进行视感知觉训练的效果。方法:选取2020年4月至2023年4月郑州市第二人民医院收治的80例间歇性外斜视患儿作为研究对象,随机数字表法分为两组,每组各40例,对照组采取矫治术及配镜治疗,观察组在此基础上增加视感知觉训练,比较两组患儿的视功能、斜视度、知觉眼位偏移情况及立体视觉。结果:观察组术后7d视功能Ⅲ级37.50%,术后1个月Ⅲ级57.50%,6个月Ⅲ级82.50%,显著优于对照组(P<0.05)。观察组看近和看远的斜视棱镜度、斜视圆周度较对照组明显减小,融合范围较对照组明显增加(P<0.05)。术后1个月、6个月,观察组患儿知觉眼位的水平和垂直偏移显著低于对照组(P<0.05)。黄斑中心凹立体视比较,术后1个月观察组与对照组分别为60.00%、30.00%,术后6个月分别为65.00%、37.50%,差异有统计学意义(P<0.05);无立体视比较,术后1个月观察组与对照组分别为2.50%、25.00%,术后6个月分别为5.00%、25.00%,差异有统计学意义(P<0.05)。结论:针对间歇外斜视患儿实施视感知觉训练可促进术后视功能的改善,减小知觉眼位偏移程度,促进立体视觉恢复,防止眼位回退,减少无立体视觉。

Objective:To explore the effect of visual perception training on children with intermittent exotropia after surgery.Method:80 children with intermittent exotropia who were admitted to the hospital from April 2020 to April 2023 were selected as the research subjects.They were randomly divided into two groups with 40 cases each using a number table method.The control group received corrective surgery and glasses therapy,while the observation group received additional visual perception training.The visual function,strabismus,perceptual eye position deviation,and stereoscopic vision of the two groups of children were compared.Result:The observation group had a grade III visual function of 37.50%7 days after surgery,a grade III visual function of 57.50%1 month after surgery,and a grade III visual function of 82.50%6 months after surgery,which was significantly better than the control group at the same time(P<0.05).The observation group showed a significant decrease in the prism and circumference of strabismus when looking closer and farther than the control group,while the fusion range increased significantly compared to the control group(P<0.05).At 1 month and 6 months after surgery,the horizontal and vertical deviation of the observation group's perception of eye position was significantly lower than that of the control group(P<0.05).The macular foveal stereopsis of the observation group and the control group were 60.00%and 30.00%at 1 month after operation,and 65.00%and 37.50%at 6 months after operation,respectively,with statistically significant difference(P<0.05).No stereopsis was 2.50%and 25.00%in the observation group and the control group at 1 month after operation,and 5.00%and 25.00%at 6 months after operation,respectively,with statistically significant difference(P<0.05).Conclusion:Implementing visual perception training for children with intermittent exotropia can promote postoperative visual function improvement,reduce perceptual eye position deviation,promote stereoscopic vision recovery,prevent eye position regression,and reduce non stereoscopic vision.