成人共同性外斜视术后双眼立体视功能重建的疗效观察

目的探讨成人共同性外斜视术后双眼立体视功能的重建效果。方法回顾性分析2009年9月至2017年11月在我科行手术治疗的44例共同性外斜视成人患者的临床资料,采用同视机及立体视检查图测定术前及术后双眼视觉功能,比较患者手术前后双眼立体视功能的变化。结果44例患者术前立体视存在率为25.0%,术后立体视存在率为68.2%,手术前后立体视存在率比较差异具有统计学意义(P<0.01);术后立体视锐度的治愈率为38.6%,好转率为25.0%,无效率为36.4%;11例术前存在立体视的患者中,术后7例达到治愈标准,1例立体视锐度好转,2例立体视锐度下降,1例立体视破坏。结论成人共同性外斜视术不仅能矫正外观,达到美容的效果,而且对部分患者可重建或改善双眼立体视功能,甚至可以达到功能治愈。术前存在立体视的间歇性外斜视患者,术后如出现眼位欠矫或过矫,可导致原有立体视下降甚至破坏。

Clinical observation of postoperative binocular stereoscopic vision reconstruction in adult concomitant exotropia

Objective To observe the reconstruction of binocular stereoscopic vision after concomitant exotropia operation in adult patients.Methods Retrospectively analyzed the clinical data of 44 adults who underwent concomitant exotropia operation in our hospital from September 2009 to November 2017.The binocular vision before and after surgery were examined with the synoptophore and digital stereogram.The change of the binocular stereoscopic vision before and after surgery was analyzed.Results The rate of stereoscopic vision in 44 patients was 25.0%before surgery,and it was 68.2%after surgery,and the difference before and after surgery was statistically significant(P<0.01).The rate of cure,recovery and inefficiency of stereoacuity were 38.6%,25.0%and 36.4%,respectively.Among the 11 patients who had stereoscopic vision before surgery,7 patients were cured,1 patient had stereoacuity improvement,2 patients underwent stereoacuity decrease,and 1 patient had stereoacuity damage.Conclusion Operation for adult concomitant exotropia improves not only the appearance of patient but also the binocular visual function.For the patients who have stereoscopic vision before surgery,postoperative undercorrection or overcorrection can lead to decline or even destruction of the original stereoscopic vision.