基本型间歇性外斜视患儿单眼遮盖试验前后斜视度的变化

Changes of the exotropia deviation in children with basic type of intermittent exotropia before and after monocular occlusion test

目的:比较单眼遮盖试验前后基本型间歇性外斜视患儿斜视度的变化。方法:前瞻性临床研究。选取2021-07/2022-09在我院行斜视矫正术的基本型间歇性外斜视患儿258例,其中男122例,女136例,年龄5-12(平均8.0±3.1)岁。术前均采用三棱镜加交替遮盖法进行视远(6 m)及视近(33 cm)的斜视度的测量,然后遮盖患儿非主导眼40 min后再次测量视远及视近斜视度,遮盖期间患儿不能闭眼及视近,打开遮盖眼之前需遮盖另眼,再交替遮盖测量斜视度。结果:单眼遮盖试验前后看远(6 m)斜视度分别为28.23^(△)±10.79^(△)、29.79^(△)±10.85^(△)(t=-0.903,P=0.368),看近(33 cm)斜视度分别为33.14^(△)±8.89^(△)、36.90^(△)±10.76^(△)(t=-2.377,P=0.019)。结论:基本型间歇性外斜视患儿术前单眼遮盖试验对视近斜视度影响大,可以暴露最大斜视度,降低斜视术后欠矫率,为斜视手术方案提供更可靠的依据。

AIM:To compare the changes of exotropia deviation in children with basic type of intermittent exotropia before and after monocular occlusion test.METHODS:Prospective clinical study.A total of 258 children with basic type of intermittent exotropia who underwent strabismus correction in our hospital from July 2021 to September 2022 were selected,including 122 males and 136 females,aged from 5 to 12 years,with an average age of 8.0±3.1 years.The exotropia deviation was measured at distance(6 m)and near(33 cm)fixation by prism alternating occlusion method,and the exotropia deviation was checked again after covering the non-dominant eyes of children for 40 min.RESULTS:Before and after the monocular occlusion test,the exotropia deviation at distance(6 m)fixation was 28.23^(△)±10.79^(△)and 29.79^(△)±10.85^(△),respectively(t=-0.903,P=0.368),while the exotropia deviation at near(33 cm)fixation was 33.14^(△)±8.89^(△)and 36.90^(△)±10.76^(△),respectively(t=-2.377,P=0.019).CONCLUSIONS:Monocular occlusion test has a great impact on the exotropia deviation at near(33 cm)fixation in children with basic type of intermittent exotropia before surgery.It can expose the maximum exotropia deviation,reduce the rate of undercorrection after strabismus surgery,and provide a reliable surgical plan.