共同性斜视手术后AC/A比率的变化

目的分析共同性斜视术后AC/A比率的变化特点及其相关的主要因素。方法AC/A比率测量同术前一样采用同视机法。随访术后≥6周病例,内斜视19例:外斜视32例。将各类型的斜视均值同其术前相应的AC/A比率均值及正常人的均值对比,并行不同术式AC/A比率均值分析。结果术后ACJA比率均值:内斜视3.16±1.15;外斜视2.32±1.03。内斜视主要类型的AC/A比率较术前下降(P<0.01),同正常人比无统计学意义(P>0.05)。外斜视分开过强型较术前下降(P<0.01),集合不足型较术前上升(P=0.012),其它类型无统计学意义(P>0.05)。外斜视仅基本型低于正常人(P<0.05)。共同性斜视的异常值均较术前显著减少(P<0.05或0.01)。各术式对内斜视AC/A比率的影响无明显差异(P>0.05),对外斜视的影响部分有差异(P<0.05或0.01)。结论手术可使共同性斜视异常的AC/A比率趋于正常。其影响与斜视的种类及类型有关,内斜视所受影响与术式无关,外斜视尚不能肯定其与术式的关系。

AC/A ratio in the patient with concomitant strabismus after surgery

Objective To analyse the AC/A ratio change after concomitant strabismus surgery and the re- lated factors of the change.Methods The AC/A ratio was measured with synoptophore before and after surgery. There were 26 patients with esotropia followed up at 6 weeks or more after surgery;37 patients with exotropia fol- lowed up.The AC/A ratios in the paients in all kinds of strabismus were analyzed to the AC/A ratios before surgery and that in the normal persons.The AC/A ratios in all kinds of strabismus patients were analyzed upon the different methods of surgery.Resdts The average AC/A ratios after surgery were 3.16:t1.15 and 2.32 1.03 in the esotropia and exotropia patients respectively.The AC/A ratios in chief types esotropia patients are decreased statisti- cally than that before surgery (p<0.05 or<0.01).but not statistically different than that in the normal persons (p>0.05).That in the divergence excess exotropia patients are decreased than that before Surgery (p<0.01)and that in the convergent insufficiency exotropia patients are increased than that before surgery (p=0.012),that of other types were not statistically different than that before surgery (p>0.05).Only that in the basic exotropia are decreased than that in the normal persons (p<0.05).The abnormal ralue of concomitant strabismus are decreased than that befor surgeren (p<0.05 or<0.01 ).There are no difference in the AC/A ratios among different kinds of surgical methOds in the esotropia patients (p>0.05).There are differences in the AC/A ratios among some kinds of surgical methods in the exotropia patients (p<0.05or<0.01).Conclusions Surgical procedure can make abnormal AC/A ratios of eon- eoitant strabismus recovered to nearly normal range.The effets of the surgical procedure depend on the kind and type of strabisinus.The relationship between the ACIA ratios and the kind of surgical method doesn't exist in the esotropia patients and was unclear in the exotropia patients.