儿童间歇性外斜视手术前后近立体视功能的观察

Research on children’s near stereopsis before and after surgical correction of intermittent exotropia

摘要:

目的:回顾儿童间歇性外斜视术前及术后6mo时眼位正位者的近立体视情况。为探讨儿童间歇性外斜视手术的合理时机选择提供判断依据。方法:回顾4～8岁儿童间歇性外斜视患者术前及术后6mo时眼位正位者78例,将其依据黄斑中心凹立体视、黄斑立体视、周边立体视分为3组,分析其术前控制正位时以及术后6mo时眼位正位者的双眼近立体视情况。结果:术前控制正位时黄斑中心凹立体视组12例,平均立体视为55.28±15.43″,黄斑立体视组56例,平均立体视为197.55±20.72″,周边立体视组10例,平均立体视为612.29±75.48″。术后黄斑中心凹立体视组立体视锐度不变,平均立体视为41.94±11.56″;黄斑立体视组恢复黄斑中心凹立体视锐度者16例,其余有不同程度提高,平均立体视为170.04±16.47″;周边注视组恢复黄斑立体视者2例,其余有一定程度的提高,平均立体视为506.40±62·53″,没有恢复黄斑中心凹立体视者。结论:儿童间歇性外斜视患者术前眼位可控制正位时近立体视功能大多已受损,手术可恢复一定的近立体视功能,但是恢复黄斑中心凹立体视功能仍有一定困难,在条件具备的前提下,早期手术对于双眼视功能的恢复有益。

Abstract:

AIM:To review the condition of near stereopsis of orthotopic children before and 6 months after the operation of intermittent exotropia and to further study the appropriate opportunity for the intermittent exotropia operation on children. METHODS: A total of 78 cases of orthotopic children (aged 4-8) before and 6 months after the intermittent exotropia operation were reviewed and divided into 3 groups: stereopsis in central macular fovea, stereopsis in the macular, and stereopsis at the edge of the fovea. The binocular near stereopsis was analyzed in the preoperative orthotopic control and 6 months after operation. RESULTS: Preoperatively, 12 cases with stereopsis in central macular fovea, the average stereopsis was 55.28±15.43″. 56 cases with stereopsis in the macular, the average stereopsis was 197.55±20.72″. 10 cases with stereopsis at the edge of the fovea, the average stereopsis was 612.29±75.48″. Postoperatively, the stereo acuity of the cases with stereopsis in central macular fovea stayed unchanged and the average stereopsis was 41.94±11.56″. No cases with stereopsis in central macular fovea got restored. The stereo acuity of 16 cases with stereopsis in the macular was restored and those of the rest improved to different extents, the average stereopsis was 170.04±16.47″. The stereo acuity of 2 cases of stereopsis at the edge of the fovea was restored and those of the rest improved to some extent, the average stereopsis was 506.40±62.53″.CONCLUSION: Before the intermittent exotropia operation was performed, the near stereopsis of children with intermittent exotropia was mostly damaged. To some extent, although the operation can help restore the near stereopsis, few cases with stereopsis in central macular fovea can get restored. When the requirements are met, early operation is beneficial to restore binocular stereopsis. 