目的：观察双侧斜肌减弱术对A-V征斜视上下方斜度矫正的临床效果，并对双侧斜肌减弱术的术后效果与A-V征斜视度数间的量效关系进行探讨。

方法：选择我院在2012-01/2016-01期间收治的A-V征患者70例70眼为研究对象，其中A征28眼，V征42眼，所有患者均进行双侧斜肌减弱术联合水平直肌矫正术。观察所有患者手术前后上下方斜视度数的改变情况，并对患者进行为期18mo的随访追踪，观察统计各患者A-V征斜视矫正的成功率。并对A-V征斜度与术中矫正的斜度、术后残余量间的量效关系进行比较分析。

结果： A-内斜、A-外斜、V-内斜、V-外斜术后上下眼位斜度差分别为-1.98^△±3.92^△、-2.25^△±4.88 ^△、2.96^△±5.29 ^△、1.91^△±4.67^△，与术前相比上下眼位斜度差显著减小，差异有统计学意义(P<0.05)。手术减少量分别为25.10^△±9.79 ^△、24.29^△±8.63 ^△、23.81^△±9.24 ^△、22.79^△±8.95^△。经18mo随访观察，A征患者矫正成功率为96%(27/28)，V征患者矫正成功率为93%(39/42)。A-V征术前斜度越高，双侧斜肌减弱术中矫正的斜度差也会相应增加，而术后斜度残余量也会随之增加。

结论：双侧斜肌减弱术能够有效地治疗A-V征斜视，显著降低患者术后上下眼位斜度。患者A-V征上下方斜度增加，手术中所矫正的斜度及术后残余量也会随之增加，存在定量关系。

METHODS: Totally 70 patients(70 eyes)with A-V syndrome treated in our hospital from January 2012 to January 2016 were enrolled in this study, including 28 eyes of A sign and 42 eyes of V sign. All patients underwent bilateral oblique muscle reduction combined with horizontal rectus correction. The changes of the upper and lower strabismus were observed before and after operation, and the patients were followed up for 18mo. The successful rate of A-V sign and strabismus correction were observed and counted. In addition, the quantitative relationship between the degree of A-V and the degree of correction and the amount of residual after operation was compared and analyzed.

RESULTS: After operation, the oblique eye position angle difference of A-esotropia, A-exotropia, V- esotropia and V-exotropia were respectively -1.98^△±3.92^△, -2.25^△±4.88^△, 2.96^△±5.29^△, 1.91^△±4.67^△, the differences were significantly compared with preoperatively(P<0.05). The reduce amount after operation were 25.10^△±9.79^△, 24.29^△±8.63^△, 23.81^△±9.24^△, 22.79^△±8.95^△. After 18mo follow-up, the success rate of A sign correction was 96%(27/28), and the successful rate of V sign correction was 93%(39/42). A-V sign, the more the oblique angle before operation, the more the correction amount during the weakening of bilateral oblique muscle, and the postoperative oblique residual increased accordingly.

CONCLUSION: Bilateral oblique muscle weakening can effectively treat strabismus with A-V sign, and can significantly reduce the upper and lower ocular gradient. The upper and lower oblique angle of the A-V sign increase, and the corrected angle and residual volume increase with the quantitative relationship.