209例A-V型斜视的临床表现和手术治疗

目的探讨A-V型斜视的病因、临床特点、手术矫正效果及手术方式。方法分析209例A-V综合征患者的临床表现、手术方式及治疗效果;所有患者依据是否伴有斜肌功能异常、原在位水平斜视及双眼单视功能情况行斜肌减弱术或/和水平肌手术,术后观察眼位、斜肌功能及双眼单视功能,随访3～24月,平均12月。结果A-V型斜视占同期斜视患者29.9%;其中,V型外斜占55.8%,A型外斜占9.1%,V型内斜占29.1%,A型内斜占6%;术后178例（85.1%）正位,192例（91.8%）A-V征消失,术后获得立体视功能者160例（76.5%）,包括术前16例具有立体视患者。结论A-V型斜视是一种常见的斜视类型,斜肌功能异常是发病的主要原因,原在位常合并水平斜视;根据是否伴有斜肌功能异常及双眼单视功能情况选择手术方式,多可获得较为满意的效果。

Clinical characteristics and surgical management of 209 cases of A and V pattern

Objective To survey the pathogeny,clinical characteristics,surgical methods and surgical effect for A and V pattern.Methods To analysis clinical characteristics,surgical methods and surgical effect of 209 cases of A-V pattern.The oblique muscles weakening and/or the horizontal muscles procedures were performed according to the dysfunction of the oblique muscles,horizontal deviation,with or without binocular vision. Follow-up after surgery was 3-24 months with mean duration of 12 months.Results A-V pattern occurred for 29.9%of all strabismus.Among A-V pattern,V-pattern exotropia occurred for 55.8%,V-pattern esotropia occurred for 29.1%,A-pattern exotropia occurred for 9.1%and A-pattern esotropia occurred for 6%.After surgery,178 （85.1%） cases got alignment,192（91.8%） cases gained A-V pattern correction and 160（76.5%） cases recovered binocular vision.Conclusions A-V pattern is a common type in strabismus,its etiology is mainly oblique muscle dysfunction.Different surgical procedures should be selected according to overaction degrees of oblique muscle and binocular vision function,which can acquire the satisfied results and binocular vision function.