双眼外直肌后徙术与常规疗法治疗斜视临床疗效比较

目的:比较双眼外直肌后徙术与常规疗法治疗斜视的临床疗效。方法:选取2016年6月-2017年6月笔者医院收治的128例斜视患者,按治疗方式不同分成对照组和研究组,每组各64例。其中对照组患者行常规单眼外直肌后徙联合内直肌缩短术(R&R),研究组患者行双眼外直肌后徙术(BLR-rec)。术后对患者随访1年,观察术后眼位正位率、欠矫率、过矫率,视觉功能恢复情况以及并发症发生率。结果:研究组患者正位率为89.06%高于对照组的68.75%,差异有统计学意义(P<0.05)。术前,对照组和研究组患者视近度、视远度和平均斜视度比较,两组患者融合功能和立体视功能占比比较,差异均无统计学意义(P>0.05)。术后,两组患者的斜视度较治疗前均出现了明显下降(P<0.05),且研究组治疗后斜视度下降幅度明显大于对照组(P<0.05);两组患者视觉功能恢复率均明显增加(P<0.05),且研究组恢复率明显大于对照组(P<0.05)。研究组并发症发生率明显低于对照组(P<0.05)。结论:双眼外直肌后徙术较单眼外直肌后徙联合内直肌缩短术有更好地临床效果,且安全性更高,值得临床推广。

Clinical Effect Comparative Analysis of Conventional Treatment and Bilateral Lateral Recession in Treatment of Strabismus

Objective To compare the clinical effect of conventional treatment and bilateral lateral recession in treatment of strabismus. Methods 128 patients with strabismus treated in our hospital from June 2016 to June 2017 were randomly divided into the two groups. There were 64 patients in each group. The patients of the control group were treated by unilateral lateral rectus recession-medial rectus recession, while the patients of the treatment group were treated by bilateral lateral recession. Two groups were both followed up for 1 year, and eye position correction rate, under correction rate, over correction rate, visual performance recovery rate and complication rate were both compared between two groups.Results In the treatment group, the eye position correction rate(89.06%) was significantly higher than control group(68.75%), and the difference was statistically significant(P<0.05). Before surgery, there was no statistically significant difference between two groups in distant vision degrees, near vision degrees and average strabismus degree(P>0.05). There was no significant difference in fusion function and stereopsis function between the two groups(P>0.05). After surgery, the strabismus degree of two groups of patients both appeared significantly decreased(P<0.05), but the strabismus degree of the patients of the treatment group decreased significantly greater than those of the control group(P<0.05). The rate of visual functional recovery of two groups were significantly increased(P<0.05), but and recovery rate of the patients of the treatment group significantly higher than that of the control group(P<0.05). And the complication rate of the treatment group significantly lower than that of the control group(P<0.05). Conclusion Bilateral lateral rectus recession on the treatment of strabismus have better therapeutic effect than unilateral lateral rectus recession-medial rectus recession, it is worthy of clinical promotion.