儿童部分调节性内斜视的手术治疗

The surgical treatment of pediatric partially accomodative esotropi-a

目的 探讨儿童部分调节性内斜视的手术时机、手术量及手术方式。方法 对38例部分调节性内斜视进行手术,手术量按裸眼和戴镜后斜视度平均值做斜视度的矫正。手术方式接远近斜视度来设计:辐辏过强型者行内直肌徙后术;基本型者行内外直肌手术;分开不足型者行外直肌缩短术。结果 38例中治愈34例占89.5％,4例良好占10.5％,21例术后获得立体视。结论 对于部分调节性内斜视由于存在调节与非调节因素,先从调节因素着手,戴全矫镜;与调节因素无关非调节因素存在的内斜,按戴镜以及裸眼平均斜视度设计手术量,以矫正眼位并尽可能恢复双眼视功能。

Objective To investigate the surgical optimal timing, extent and methods for pediatric partially accommodative esotropia. Methods 38 cases of pediatric partially accommodative esotropia were treated by surgery. The amount of surgery was determined by the average diopters of esotropia without and with correction. Surgical methods were designed by esotropia at near and distance fixation: medial rectus muscle recession was used to excessive convergence patients, lateral rectus muscle resection was used to insufficient deviation ones,both medial and lateral muscles was used to basic esotropia.Results In the 38 cases,34(89.5% ) were cured and 4 (10.5%) improved,21 cases got stereopsis.Conclusion In the treatment of partially accommodative esotropia, accommodation should be the fist factor to be managed (prescribe a glass for all correction) and the residual deviation correction should be designed according to the esotropia with and without glass.