单眼严重白内障伴外斜视患者临床疗效观察

目的：观察单眼严重白内障合并外斜视患者术后临床效果。 方法：回顾我院2010-03/2012-12单眼严重白内障合并外斜视行白内障摘除联合人工晶状体植入手术的患者资料45例。术前44例较差眼视力均〈0.05,1例2岁患儿无法配合视力检查。随诊观察术后6mo患者的最佳矫正视力、眼底、斜视度、双眼单视功能及复视情况。 结果：先天性白内障患者2例中有1例患儿2岁,无法配合视力及复视检查,眼底正常；另1例患儿术后无同时知觉,无复视。5例不明原因中青年单眼白内障患者中,有3例患者术后视力〉0.6,眼底正常,术后眼位正,有双眼单视；2例患者术后视力为指数,眼底有异常,术后斜视度与术前无变化,无同时知觉,无复视。38例老年性白内障患者中,有31例患者术后有双眼单视；3例患者术后斜视度与术前无差异,无同时知觉,无复视；3例患者术后斜视度与术前无差异,有复视,6mo内复视均自行消除；1例患者外斜10o,术后出现复视,且6mo内无改善,可用12？矫正,建议戴镜治疗。 结论：单眼严重视力障碍合并外斜视的成年患者多数术后可自行纠正眼位,获得一定的双眼单视功能。

Clinical effective observation on monocular serious cataract with exotropia

AIM: To evaluate the clinical effect of surgical treatment on monocular serious cataract with exotropia.

METHODS: Reviewed 45 patients diagnosed as cataract with exotropia who accepted cataract surgery and intraocular lens implantation from Mar. 2010 to Dec. 2012 in our hospital. Preoperatively the visual acuity of 44 patients was<0.05. One 2-year old child couldn't cooperate with the examination. The best-corrected visual acuity(BCVA), fundus, strabismus, binocular single vision(BSV)and diplopia condition were observed postoperative 6 months.

RESULTS: One 2-year old child couldn't cooperate with the examination. The other congenital cataract patient didn't acquire BSV and diplopia. Among 5 middle-aged patients, the BCVA of 3 cases were above 0.6 with normal fundus and BSV, 2 cases were finger count with abnormal fundus and without BSV. Among 38 senile cataract cases, 31 cases acquired BSV, 3 cases without BSV and diplopia, 3 cases appeared diplopia postoperatively and recovered in 6 months, 1 case with exotropia and diplopia accepted triple prism treatment.

CONCLUSION: Most of adult patients with monocular serious cataract andexotropia can acquire normal eye position and BSV.