不同屈光状态急性共同性内斜视患者的临床特征及治疗体会

Clinical characteristics and treatment of patients with acute acquired concomitant esotropia in different refractive status

摘要:

目的：分析不同屈光状态急性共同性内斜视患者的临床特征及治疗情况。

方法：回顾分析2020-01/2022-01我院收治的非Ⅰ型急性共同性内斜视患者110例，根据治疗前屈光状态分为非近视组(30例，等效球镜>-0.5D)和近视组(80例，等效球镜≤-0.5D)，分析两组患者治疗前斜视度、AC/A值、视功能情况及手术方式和术后复发情况等。

结果：非近视组患者裸眼视近斜视度\〖(47.13±23.54)^△\〗与视远斜视度\〖(48.90±22.59)^△\〗无差异(P>0.05)； 近视组患者裸眼视近斜视度\〖(40.49±26.09)^△\〗小于视远斜视度\〖(50.09±25.41)^△\〗(P<0.001)； 两组患者相同距离斜视度无差异(P>0.05)。非近视组患者AC/A值(5.40±2.23)大于近视组(3.14±3.10)(P<0.05)。近视组患者近立体视优于非近视组(P<0.05)。非近视组手术方式多样，近视组多采用外直肌缩短和/或内直肌后退术。

结论：不同屈光状态均可发生急性共同性内斜视，非近视者远、近斜视度无明显差异，AC/A值高，手术方式多样； 近视者视近斜视度小于视远斜视度，AC/A值正常，近立体视更佳，多采用外直肌缩短和/或内直肌后退术。

Abstract:

AIM: To analyze the clinical characteristics and treatment of patients with acute acquired concomitant esotropia(AACE)in different refractive status.

METHODS: A retrospective analysis was conducted on 110 patients with non-type I AACE treated from January 2020 to January 2022. The non-myopic group(30 cases, spherical equivalent>-0.5D)and the myopic group(80 cases, spherical equivalent≤-0.5D)were divided according to the refractive status. The degree of deviation, accommodative convergence and accommodation ratio(AC/A), visual function, and surgical methods were observed.

RESULTS: The non-myopic group had no difference in the degree of near deviation \〖(47.13±23.54)^△\〗 and the degree of distant deviation \〖(48.90±22.59)^△\〗(P>0.05); near deviation \〖(40.49±26.09)^△\〗 of myopic group was less than distant deviation \〖(50.09±25.41)^△\〗(P<0.001); and there was no difference in the same distance between the two groups(P>0.05). AC/A in the non-myopic group(5.40±2.23)was higher than that in the myopic group(3.14±3.10; P<0.05). Patients in the myopic group had better near stereopsis than the non-myopic group(P<0.05). The non-myopic group had a variety of surgical methods, while the myopic group mostly used lateral rectus resection or/and medial rectus recession.

CONCLUSION: AACE can occur in different refractive status. Non-myopic patients have the same degree of distant and near strabismus, high AC/A, and varied surgical methods. However, myopic patients have less degree of near deviation than distant deviation and have normal AC/A and better near stereopsis, and lateral rectus resection or/and medial rectus recession are commonly used.