52例III型急性共同性内斜视术后视功能分析

Analysis of Binocular Visual Function in 52 Cases of Acute Acquired Concomitant Esotropia Type III

目的:分析III型急性共同性内斜视术前与术后双眼视功能的变化。方法:回顾性分析2017年1月至2018年12月就诊于厦门眼科中心并行手术治疗的AACE (III)型患者52例,发病年龄15~41岁,性别男30例,女22例,屈光度?2.25 D~?6.50 D,最佳矫正视力0.8~1.0。33 cm斜视度+15^+25 PD,6 m斜视度+18^+40 PD,病程6月~3年,其中病程6月~1年组27例,】1年组25例,术前23例配戴压贴三棱镜,配戴时间】6月。评估术前及术后3个月双眼视的变化,近立体视和远立体视分别采用Titmus、同视机检查。结果:52例患者术后复视消失。病程6月~1年组术后分别有24例和21例获得了远立体视和近立体视;病程】1年组术后分别有15例和13例获得了远立体视和近立体视,同视机检查结果组间比较,无显著性差异(p 】0.05),Titmus检查结果组间比较,差异有显著性(p 0.05),Titmus检查结果组间比较,差异有显著性(p 【0.05)。结论:III型急性共同性内斜视病程超过1年,近立体视丢失几率增加。及时配戴三棱镜能够有效的保留近立体视。近立体视的丢失要早于远立体视,术后恢复亦较远立体视难度大。建议发病6个月后手术治疗,消除复视,改善外观,重新建立双眼视功能。

Objective: To investigate the changes of binocular visual function in acute acquired concomitant esotropia (ACCE) type III after surgery. Methods: This was a retrospective study. 52 cases of AACE (III) aged 15 - 41 years (30 males and 22 females) were treated in the Strabismus and Pe-diatric Ophthalmology Service of Xiamen eye center from January 2017 to December 2018. The range of Diopter was from ?2.25 D to ?6.50 D. The best corrected visual acuity was 0.8 - 1.0. The degree of strabismus in 33 cm and 6 m distance was +15 - +25 PD and +18 - +40 PD. The degree of distance strabismus and near strabismus was consistent in 10 cases, and the degree of dis-tance strabismus was larger in 40 cases. The course of disease was between 6 months and 3 years (6 months to 1 year in 27 cases and over 1 year in 25 cases). The press-on prism was worn in 23 cases over 6 months before surgery. The biocular vision function before and after surgery was evaluated. Near stereoacuity and distance stereoacuity were investigated by Titmus and synoptophore at postoperative 3 months. Results: 52 cases of ACCE were completely orthotopic after surgery and their diplopias disappeared. In group with course of 6 months to 1 year, 24 cases and 21 cases achieved distance stereoacuity and near stereoacuity. In group with course over 1 year, 15 cases and 13 cases achieved distance stereoacuity and near stereoacuity. The differences in data by synoptophore between groups were not significant (p >0.05), but data by Titmus were statistically different (p 0.05), but data by Titmus were sta-tistically different (p