V型外斜视的临床表现和手术治疗分析

目的 探讨V型外斜视的病因、临床表现及手术治疗效果.方法 分析2004年1月至2008年6月收治1340例斜视中76例V型外斜视病例的病史资料及治疗结果.根据不同临床表现和病因,行不同的手术方式,术后进行双眼视功能训练,随访6～12月.结果 76例v型外斜视患者中,共有73例(96.05%)患者存在眼外肌功能异常,包括下斜肌功能亢进患者56例(73.68%)、上斜肌功能不足39例(51.32%)、上直肌功能减弱8例(10.53%)、下直肌功能亢进2例(2.63%)、外直肌功能亢进33例(43.42%)和内直肌功能不足4例(5.26%o术后共有65例效果满意(85.53%),第一眼位正,v征消失,59例(77.63%)通过手术和训练获得了双眼视功能.结论 V型外斜视发病原因以下斜肌功能亢进为主,根据病因选择不同的手术方式,术后配合双眼视功能训练,多能获得双眼视.

Clinical features and surgical treatment of Vpattern exotropia

Objective To analyze the etiology,clinical characteristics and surgical management for the correction of V pattern exotropia.Methods The case history and surgical effect of 76 V-pattern exotropia in 1340 strabismus were studied.The way of performing surgery depends on clinical manifestation and etiology.Follow-up after surgery was 6-12 months,with mean duration of 9 months.Results The etiology of V pattern exotropia was mainly extraocular museles disfunction (96.05%),including inferior oblique muscle overaction (73.68%),superior oblique muscle underaction (51.32%),superior rectus dysfunction (10.53%),inferior rectus overaction (2.63%),lateral rectus overaction (43.42%),medial rectus disfunction (5.26%).85.53% of surgical treatment acquired the satisfied result,with orthophoria,no V sign.By function training,77.63% of patients got binocular vision.Conclusions The etiology of V pattern exotropia is mainly inferior oblique mus- cle overaction.According to its etiology,different surgical procedure arc chosen,combinating with visual func- tion training,which can acquire binocular vision.