影响成人间歇性外斜视术后立体视功能重建情况分析

Stereoscopic reconstruction in adults with intermittent exotropia after surgery

摘要:

目的：调查成人间歇性外斜视术后立体视功能重建情况，并分析影响患者立体视功能重建的相关因素。方法：回顾性研究。选择2019-01/2021-01我院收治间歇性外斜视成人患者196例，所有患者均行斜视矫正手术，收集患者术前一般资料和术后患者立体视功能重建情况。结果：纳入患者196例术前均无近远立体视觉功能，术后近立体视觉功能重建率为52.6%(103/196)，远立体视功能重建率为50.5%(99/196)。近立体视功能重建(103例)与未重建患者(93例)手术年龄、发病年龄、病程、术后水平斜视量等因素比较存在统计学意义(P<0.001)； 多因素Logistic回归分析显示发病年龄、病程、术后水平斜视量是影响近立体视功能重建的因素(P<0.05)； 受试者操作特征(ROC)曲线显示，发病年龄、病程、术后水平斜视量用于预测患者近立体视功能重建曲线下面积(AUC)分别为0.757、0.737、0.727(P<0.001)。远立体视功能重建(99例)与未重建患者(97例)在手术年龄、发病年龄、病程、术后水平斜视量比较存在统计学意义(P<0.001)，多因素Logistic回归分析显示发病年龄、病程是影响患者远立体视功能重建的因素(P<0.05)； ROC曲线显示，发病年龄、病程用于预测患者远立体视功能重建AUC分别为0.672、0.821(P<0.001)。结论：成人间歇性外斜视术后立体视功能重建受到发病年龄、病程等因素影响，近立体视功能重建与远立体视功能重建的影响因素有所差异，临床上需要重点关注。

Abstract:

AIM: To investigate the status of stereoscopic reconstruction in adults with intermittent exotropia after surgery, and analyze related influencing factors.METHODS: A retrospective study was conducted among 196 adults with intermittent exotropia who were admitted to our hospital from January 2019 to January 2021. All patients underwent strabismus surgery, and their preoperative and postoperative data were collected.RESULTS: Near and distal stereo visual function was not found in all the included 196 patients before surgery. The reconstruction rates of near stereo visual function and distal stereo visual function were 52.6%(103/196)and 50.5%(99/196), respectively. There were significant differences in surgical age, age of onset, course of disease, and postoperative level of horizontal strabismus between patients with near stereoscopic reconstruction(103 cases)and those without reconstruction(93 cases; P<0.001). Multivariate Logistic regression analysis showed that age of onset, course of disease, and postoperative level of horizontal strabismus were factors influencing near stereo visual function reconstruction(P<0.05). The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)values of age of onset, course of disease and postoperative level of horizontal strabismus to predict near stereo visual function reconstruction were 0.757, 0.737 and 0.727, respectively(P<0.001). There were significant differences in surgical age, age of onset, course of disease, and postoperative level of horizontal strabismus between patients with distal stereoscopic reconstruction(99 cases)and those without reconstruction(97 cases; P<0.001). Multivariate Logistic regression analysis showed that age of onset and course of disease were factors influencing distal stereo visual function reconstruction(P<0.05). ROC curve showed that the AUC values of age of onset and course of disease to predict distal stereo visual function reconstruction were 0.672 and 0.821, respectively(P<0.001).CONCLUSION: Stereoscopic reconstruction in adults with intermittent exotropia after surgery is affected by many factors, such as age of onset and course of disease. The influencing factors of near stereo visual function reconstruction and distal stereo visual function reconstruction are different, which deserves attention.