单眼一退一缩术式矫正集合不足型间歇性外斜视短期效果分析

目的：观察一退一缩术式对集合不足型间歇性外斜视的效果和术后回退程度。

方法：对45例集合不足型间歇性外斜视患者由同一术者进行单眼一退一缩术式后，检查术后1d，2wk的斜视度，并进行统计分析。

结果：集合不足型间歇性外斜视患者45例进行单眼一退一缩术式后，术后1d，视远平均过矫8.27±7.17PD，视近平均过矫2.40±8.86PD，术后2wk视远平均欠矫1.18±6.98PD，视近平均欠矫4.36±7.83PD。术后2wk内，视远平均回退9.45±6.40PD，视近平均回退6.77±7.92PD。视远及视近回退呈正相关。术后2wk视远视近斜视度差异(3.18±5.60PD)较术前(7.65±6.55PD)明显减小，两者呈正相关。

结论：集合不足型间歇性外斜视患者适合一退一缩术式，适当加大内直肌手术量可减少术后远近斜视度的差异，且不改变患者内外直肌的张力状态。术后视远视近回退呈同步状态，视远约回退10PD，术后近期过矫10PD可有利于远期正位。

Short-term effect of unilateral recession-resection procedure for intermittent exotropia with insufficient collection

AIM: To investigate the effect and binocular alignment of unilateral recession-resection(R-R)procedure in patients with insufficient convergence intermittent exotropia(IXT).

METHODS: Totally 45 patients with insufficient convergence IXT were operated with unilateral R-R procedure. Binocular alignment was accessed 1d postoperative and 2wk postoperative. Statistical analysis was performed on squint at different time points.

RESULTS: All 45 patients with insufficient convergence IXT were operated with unilateral R-R procedure. On the 1^st day after surgery, an overcorrection of 8.27±7.17PD at distance and 2.40±8.86PD at near were seen. On the 2wk after surgery. An under correction of 1.18±6.98PD at distance and 4.36±7.83PD at near were seen. Within 2wk after surgery, the average exo-drift at distance was 9.45±6.40PD, and at near was 6.77±7.92PD. There was statistically significant difference between exo-drift at distance and near, and a positive correlation was discovered. The difference of near-distance squint at postoperative(3.18±5.60PD)was significantly lower than that of preoperative(7.65±6.55PD), and there was a positive correlation between them.

CONCLUSION: Unilateral R-R procedure is appropriate for patients with insufficient convergence IXT. An appropriate increase of medial rectus strengthening can reduce postoperative near-distance squint difference and does not change the tension of medial rectus and lateral rectus. There was a synchronized exo-drift both at distance and near. The postoperative exo-drift at distance was 10PD and we believe a 10PD overcorrection shortly after operation may be beneficial to the long-term binocular alignment.