A-V综合征术后立体视的变化

目的观察A．V综合征患者斜视术后立体视的变化。方法前瞻性系列病例研究。4-8岁A．V综合征患者83例，矫正视力在0．6-1．0之间，双眼视力平衡。其中V征48例（外斜V征35例，内斜V征13例），平均年龄（5．3±0．8）岁；A征35例（外斜A征26例，内斜A征9例），平均年龄（5．5±1．1）岁。术后随访时间12-18周。采用同视机和Titmus立体视图本分别判断是否存在远、近立体视觉。数据采用×：检验进行分析。结果72例患者获得完全眼正位。V征组患者术前及术后存在远立体视者分别为5例（10％）和13例（27％），差异有统计学意义（X^2=4．376，P=0．036）；存在近立体视者分别为8例（17％）和17例（35％），差异有统计学意义（X^2=4．381，P=0．036）。A征组患者术前及术后存在远立体视者分别为4例（11％）和8例（23％），差异无统计学意义；存在近立体视者术前和术后分别为5例（14％）和11例（31％），差异无统计学意义。A征组与V征组患者术前和术后立体视变化比较差异无统计学意义。结论A-V型斜视破坏立体视明显，手术矫正眼位有助于双眼单视的恢复。

Changes in the stereopsis of A- and V- pattern strabismus patients after surgery

Objective To investigate the change in the stereopsis of A- and V- pattern patients after strabismus surgery. Methods In this prospective case series study,83 patients with A- or V-pattern strabismus were recruited, including 48 V-pattern patients [35 exotropes and 13 esotropes, mean age （5.3~0.8）years] and 35 A-pattern patients [26 exotropes and 9 esotropes, mean age （5.5±1.1）years]. Best corrected visual acuity was between 0.6 to 1.0 for all patients. Routine strabismus surgeries were performed and the patients were followed up for 12 to 18 weeks. Distance and near stereopsis were determined with a synoptophore and Titmus tests, respectively. Data were analyzed with a chi-square test. Results Complete orthotropia was obtained in 72 of 83 patients. For the V-pattern patients, distance stereopsis was present in 5 cases （10%） before surgery and in 13（27%） after surgery （X^2=4.376, P=0.036）. Near stereopsis was present in 8 cases （17%） before surgery and in 17（35%） after surgery （X2=4.381, P=0.036）. For the A-pattern patients, distance stereopsis was confirmed in 4 cases （11%） before and in 8（23%） after surgery, and near stereopsis was found in 5 cases （14%） before and 11（31%） after surgery, both far and near stereopsis between before and after surgery were without significant. There was no statistical difference in the change in stereopsis between A- and V-pattern patients. Conclusion Correction of deviation by surgery may contribute to the re-establishment of stereopsis in A- and V-pattern strabismus patients.