间歇性外斜视治疗对策设计研究及随访观察

目的研究探讨不同斜视度数间歇性外斜视的临床治疗对策。方法对不同斜视度数的92例间歇性外斜视患者根据临床症状、斜视角大小和双眼视功能的检测结果进行分组设计治疗对策。结果A组35例。其中16人斜视角增大伴有不同程度视功能丢失趋势(45.71%),需融合功能训练。8人(22.86%),需手术治疗。B组16例,训练前、后远近斜视角、辐辏性融合范围、远、近立体视差异无统计学意义(P>0.05)。C组41例,手术前有、无融合功能与术后正位率差异无统计学意义(P>0.05),而术后融合功能训练后有、无融合功能与术后正位率差异有统计学意义(P<0.01)。结论①正确判断间歇性外斜视的双眼视功能状况是设计治疗对策的基础。②小度数患者加强随访观察及非手术治疗,部分病例可暂时控制病情。③术后融合功能的建立和巩固可预防眼位回退及提高功能治愈率。

The design and observation of the treatment ways of the intermittent exortopia

Objective To study and explore the treatment plays of the intermittent exotropia with different degree. Methods 92 patients with intermittent exotropia are divided into groups. according to clinical symptom. exotropia degree and the exam results of binoculor vision function. Design the treatment ways. Results The average follow-up time is 6 months. The group A includes 35 cases, of which 16 cases (45.71%) the exotropia degree are developed and the binocular vision function tend to weaken, 8 cases (22.86%) need operation. The group B includes 16 cases, There is no significant different in exotropia degree, fusion function and stereopsis at 33cm and 5m distance. (P>0.05). before and after the training. the group c with 41 cases. Before pro-operation, It makes no great difference whether or not there is fusion function and normal eye position rate. (P>0.05). But there are significant differences after training. at post-operation. (P<0.01). Conclu- sions (1) An accurate judgement about the binocular vision function of intermittent exotropia. is the base of making an effient treatment plan. (2) Close observation and treatment without operation. can control the exotro- pia with small degree. temporarily. (3) Creating and consolidating the fusion function of the post-operation patients can have an effective control on their normal eye position and recovery of binocular vision function.