传统与欠矫手术治疗部分调节性内斜视的比较

目的：评估传统与欠矫手术治疗部分调节性内斜视患者的效果。方法：将25例具有部分调节性内斜视和正常AC／A的患者随机分为两组，其中13例患者接受传统手术治疗，其余12例患者接受欠矫手术治疗。传统手术是基于远距远视完全矫正所测量的偏差上，而欠矫手术比传统手术标准低20％。所有患者均进行对称性双眼内直肌后退术，术后随访6mo。结果：术后6mo，传统组与欠矫组手术成功率分别为46％和91％（成功标准定义为通过近距和远距远视的完全矫正斜视≤8^△）。传统组和欠矫组的手术过矫率分别为54％和9％，两组间差异有统计学意义（P〈0．05）。没有残余内斜视。手术成功率或欠矫率与患者的年龄、术前等效球镜均值、术前眼偏斜量无相关性。结论：对于具有正常AC／A的部分调节性内斜视患者，欠矫的双眼内直肌后退术成功率较高，过矫率较低。

Comparison of standard and undercorrected surgica methods for treating partially accommodative esotropia

AIM： To evaluate the efficacy of standard and undercorrected surgical methods in patients with partially accommodative esotropia （PAET）.
METHODS： Twenty-five patients with PAET and normal accommodative convergence/accommodation （ AC/A ） were divided into two groups for alternate surgical plan including standard method （13 patients） and undercorrected method （12 patients） in a randomized fashion. Standard method is based on measured deviation through full hyperopic correction at distant target and was performed by Parks scheme. Undercorrected method criteria is 20% lower than standard. All patients underwent symmetrical bilateral medial rectus recessions （BMR）, and all of them were followed for 6 months.
RESULTS： Six months after operation, surgical success （defined as tropia ≤ 8^△ at distant and near fixation through full hyperopic correction） was 46% in standard group and 91% in undercorrected group. Overcorrection were observed 54% in standard group and 9% in undercorrected group （ P 〈 0.05）. There was no residual esotropia. There was no correlation between surgical success rate or overcorrection rate and age, mean of preoperative spherical equivalent or preoperative eye deviation.
CONCLUSION： Undercorrected BMR surgery has a lower overcorrection rate and higher surgical success rate than standard surgery in patients with PAET and normal AC/A.