间歇性外斜视患者的屈光状态对术后短期立体视功能重建的影响

目的 比较不同屈光状态的间歇性外斜视患者术后立体视功能重建的差异。设计 回顾性病例系列。研究对象 北京同仁医院2014年7月至2015年8月被诊断为间歇性外斜视已经接受手术治疗的患者227例。方法 将患者按照屈光状态分为远视组、正视组、近视组和屈光参差组，比较分析四组患者术前术后的远近立体视功能状况。主要指标 远立体视功能和近立体视功能。结果 （1）不同屈光状态组患者术后1个月以眼位评价的手术成功率无统计学差异（P=0.775）。（2）远视、正视、近视和屈光参差组的患者术前远立体视保存率分别为24.1%、16.3%、20.5%和20.0%（P=0.802），术后1个月远立体视保存率分别为17.2%、26.3%、41.1%和24.4%。正视、近视和屈光参差组患者术后的远立体视的保存率均较术前有所提高，但只有近视组患者的术后远立体视保存率的提高有统计学意义（P=0.001）。（3）远视、正视、近视和屈光参差组的患者术前近立体视保存率分别为65.5%、81.3%、82.2%和64.4%，术后1个月近立体视保存率分别为65.5%、87.5%、90.4%和62.2%，正视组和近视组的患者术前术后的近立体视保存率均高于远视组和屈光参差组（P均＜0.05）。结论 合并近视的间歇性外斜视患者术后短期内的远立体视功能重建优于合并远视、正视及屈光参差的患者。

Effects of refractive errors on postoperative short-term stereoacuity reconstruction in patients with intermittent exotropia

Objective To compare the postoperative short-term stereoacuity reconstruction with respect to refractive errors in intermittent exotropia (IXT). Design Retrospective case series. Participants 227 patients with IXT who had received strabismus surgeries in Beijing Tongren Hospital from Jul. 2014 to Aug. 2015 were involved. Methods All patients were divided into four groups according to preoperative refractive error: IXT with hyperopia (group I), IXT with emmetropia (group II), IXT with myopia (group III), and IXT with anisometropia (group IV). The preoperative and postoperative stereoacuity at distance and near were compared among the four groups. Main Outcome Measures Stereoacuity at distance and near. Results (1) The success rates of surgery depending on postoperative ocular alignment had no significant difference among different groups (P=0.775). (2) The preoperative ratio of having distance stereoacuity in group I, II, III and IV was 24.1%, 16.3%, 20.5%, 20.0%, respectively; and the postoperative ratio was 17.2%, 26.3%, 41.1%, 24.4%, respectively. There was no significant difference in preoperative distance stereoacuity among the four groups (P=0.802). The postoperative ratio of having distance stereoacuity increased in IXT patients with emmetropia, myopia and anisometropia, while only the increase of IXT patients with myopia was statistical significant (P=0.001). (3) The preoperative ratio of having near stereoacuity in group I, II, III and IV was 65.5%, 81.3%, 82.2%, 64.4%, respectively; and the postoperative ratio was 65.5%, 87.5%, 90.4%, 62.2%, respectively. The preoperative and postoperative ratios of having near stereoacuity in IXT with emmetropia and myopia were higher than that in IXT with hyperopia and anisometropia (all P<0.05). Conclusion The postoperative short-term distance stereoacuity reconstruction in IXT patients with myopia was better than that in IXT patients with hyperopia, emmetropia and anisometropia.