大角度斜视伴弱视早期手术的疗效

目的探讨大角度斜视伴弱视患儿早期手术的疗效。方法35例35眼大角度斜视伴弱视患儿中，24眼斜视度〉20°以上、视力〈0．3者，尽早行斜视矫正术；其余注视性质不良者11眼，先行后像增视或红色滤光片法训练，改善其注视性质后尽早行斜视矫正术。术后均进行强化综合弱视训练。结果术后6个月眼位正位25眼，欠矫8眼，过矫2眼；弱视基本痊愈12眼，进步19眼，无效4眼，总有效率88．6％．1a后眼位正位24眼，欠矫10眼，过矫1眼；弱视基本痊愈16眼，进步19眼，无效0眼。术后6个月和1a的眼位正位率分别为71、4％和68．6％，经统计学处理无显著性差别（P〉0．05），眼位控制稳定。结论大角度斜视伴弱视患儿，早期手术矫正斜视，有利于视力、双眼视功能恢复．且眼位控制稳定。

Therapeutic effect of early surgery for patients with both lar-geangle strabismus and amblyopia

Objective To investigate the therapeutic effect of early surgery for patients with both large-angle strabismus and amblyopia.Methods In 35 children(35 eyes) with both large-angle strabismus and amblyopia,the early strabismic surgery was performed in 24 eyes,whose deviation angle was larger than 20 dioper and visual acuity was lower than 0.3.In other 11 eyes with bad focus nature,the image therapy or red filter training was made firstly to improve their focus nature,and the strabismic surgery was taken as soon as the focus nature improved.All the patients got the continued intensive amblyopia training after surgery.Results At 6 months postoperatively,the position of eye became orthotropia in 25 eyes,residual anorthopia in 8 eyes,and over-treated in 2 eyes,the normotopia rate was 71.4%;The amblyopia was cured basicly in 12 eyes,improved in 19 eyes,ineffective in 4 eyes,the total effective rate was 88.6%.At 1 year postoperatively,the position of eye became orthotropia in 24 eyes,residual anorthopia in 10 eyes,and over-treated in 1 eye,the normotopia rate was 68.6%.The amblyopia was cured basicly in 16 eye,improved in 19 eyes,ineffective in 0 eye.There was no significant statistical difference in the normotopia rate between 6 months and 1 year after surgery(P>0.05).Conclusion The correct strabismic surgery performed in patients with both large-angle strabismus and amblyopia timely can benefit to the recovery of visual acuity and binocular single vision,and the stability of eye position.