小度数内斜视矫正术前戴三棱镜治疗临床研究

目的 提高小度数内斜视矫正手术的正位率和功能治愈率,扩大小度数内斜视的手术范围.方法 在手术前平均16个月内给33例斜视度为+7△～+20△的小度数内斜视患者佩戴压贴三棱镜,以抵消内斜视角度.结果 33例患者戴三棱镜后28例(84.8%)斜视角度增加≥+5△,从而使12例初始斜视度＜+15△的患者也获得了手术治疗.实验组33例巾,远期正位31例(93.9%),对照组21例中,远期正位14例(66.7%),实验组正位率明显优于对照组(x2=7.407,P=0.025).实验组有15例(45.5%)获得≤60"的近距离市体视锐度,11例(33.33%)获得≤60"的远距离立体视锐度;对照组有2例(9.5%)获得≤60"的近距离立体视锐度,1例(4.8%)获得≤60"的远距离立体视锐度.实验组的功能治愈率明显优于对照组(近立体视:x2=24.106,P=0.000;远立体视:x2=13.137,P=0.004).结论 小度数内斜视患者通过在手术前长期佩戴三棱镜可准确地确定手术目标斜视角,扩大手术范围,并使患者在手术前建立一定程度的双眼视觉,从而提高了手术的成功率.

The Clinical Research about Patient with Small Angle Esotropia Worn Prism Lens before Operation ABSTRACT

Objective To improve the orthophoria rate and functional recovery rate after small-angle esotropia surgery,and to expand the range of surgery of small angle esetropia.Methods Press-On prism were used for 33 patients with small-angle(+7～+20 △)esotropia in the average 16 months before surgery to counteract the angle of esetropia.Results In 33 patients worn prism lens,28 patients' angle of esotropia increase five degrees at least.It make the 12 patients whose initial angle of esotropia is less than 15△ to obtain surgery too.In the experimental group,there were 31 out of 33 cases(93.9%),while in the control group 14 out of 21 eases(66.7%)with long-dated orthophoria.The orthophoria rate of experimental group was apparently better than of the control group(x=7.407,P=0.025).In the experimental group,15 cases(45.5%)obtained near distance stereoacuity of ≤ 60",11 cases(33.3%)obtained far distance stereoaeuity of ≤60 ".In the control group,2 eases(9.5%)obtain of≤60 ",1 case(4.8%)obtained far distance stereoacuity of≤60".The rate of functional recovery of experimental group was better than of the control group apparently(near distance stereoacuity:x=24.106,P=0.000;far distance stereoacuity:x=13.137,P=0.004).Conclusions Through patients wear the prism lens in long-term before the surgery,patients' the target angle can be determined accurately and the range of this surgery can be expanded.Patients can obtain binocular vision before surgery,so the achievement rate of surgery could be improved.