外斜视术后远期眼位变化及相关影响因素的研究

目的 观察外斜视患者术后远期眼位变化并分析其相关影响因素.方法 对28例外斜视手术患者随访观察,分别于术后第3d和术后1年用三棱镜遮盖法检查患者斜视度;同视机和Titmus立体图检查立体视觉.术后眼位正位标准为斜视角≤±10△.所有结果采用SPSS 17.0统计软件统计学处理.结果 术后第3d和术后1年的眼位正位率为96.4％和64.3％,斜视度平均值为-4.32△±4.57△和 -8.64△±8.70△,经统计学分析有显著性差异(t=-0.445,P=0.01 3),术后1年斜视度回退量均值为-4.32△±8.61△.对16例患者术前和术后的立体视锐度进行比较,发现术后立体视锐度较术前有所提高,但术前立体视锐度与远期眼位变化无明显相关性其它因素如患者手术年龄,术前斜视度等对术后远期眼位无明显影响.结论 外斜视患者斜视矫正术后远期眼位有回退现象,单因素如术前立体视锐度、手术年龄、术前斜视度等与其无明显相关性,眼位回退可能受多种因素的共同影响.

Long-term postoperative drift of exotropia and evaluation of related factors

Objective To investigate the postoperative drift of exotropia and evaluate the potential related factors.Methods 28 exotropic patients who underwent surgery and had a year of follow-up were evaluated.The deviation were measured by prism plus cover testing in the 3rd day and 1 year after surgery.The stereoacuity were assessed by Titmus strergram in pre-and post-operation respectively.A successful surgical alignment was defined as within ±10△.All results were analyzed by SPSS17.0.Results 27 of the 28 cases(96.4%) had a successful surgical alignment in the 3rd day,and 18(64.3%) were achieved within 10△ of orthotropia at 1 year after surgery.The mean deviation were-4.32△±4.57△ and-8.64△±8.70△ in the postoperative 3rd day and a year respectively.Statistics showed there was significant difference between them.The ocular alignment at a year had a significantly exotropic drift than in the 3rd day after surgery(t=-2.665,P=0.013);The mean recurrenct value was-4.32△±8.61△.16 cases were examined stereoacuity with Titmus strergram in pre-and post-operation.It was proved that the postoperative stereoacuity had improved than preoperative one.(Z=-2.280,P=0.023).The age at surgery,stereoacuity,and preoperative deviation were proved to be no significant associated with the long-term postoperative drift of exotropia.Conclusions Patients with exotropic surgery had a long-term postoperative drift of exotropia.The mean recurrenct value was-4.32△±8.61△ at a year after surgery.The final postoperative ocular alignment would not be inflenced by a single factor such as the age at surgery,stereovision,and preoperative deviation.