大角度基本型外斜视主眼与非主眼手术的疗效比较

目的：探讨治疗大角度基本型外斜视的最佳手术方法。方法：分别对斜视度数≥60的基本型外斜视患者41例,使用主眼手术和非主眼手术两种方法治疗,同时记录,比较手术后患者的视力,眼位,双眼单视功能,注视等情况,以及平均手术量和手术次数等,并进行统计学分析。结果：两组患者术后双眼正位者均为39例,手术欠矫者均为2例,无过矫者;两组患者术后注视情况均好转;主眼手术组非主眼裸眼视力提高＞2行者多于非主眼手术组,差异有显著意义（P＜0．05）;术后Ⅰ,Ⅲ级视功能者主眼手术组多于非主眼手术组,差异有显著意义（P＜0．05）,主眼手术组平均手术量和手术次数明显低于非主眼手术组,两组比较差异有非常显著意义（P＜0．01）;主眼手术组眼外肌1mm手术量可矫正的平均斜视度数明显大于非主眼手术组,两组比较差异有非常显著意义（P＜0．01）。结论：治疗大角度基本型外斜视患者,主眼手术方法疗效好,损伤轻,值得推广使用;尤其以需在全麻下进行手术的儿童患者更具有临床意义。

A comparison of master eye operation with slave eye operation on patients with large-angle exotropia

OBJECTIVE: To search for an excellent therapy for patients with large-angle exotropia. METHODS: Strabotomy was performed on the master eyes in the 41 cases (master eye group) and slave eyes in the other 41 cases (slave eye group) with large-angle exotropia (>/= 60(Delta)). The post-operative visual acuity, ocular position, visual function and fixation, the average surgical amount and the frequency of strabotomy were statistically compared between the two groups. RESULTS: Post-operatively, orthophoria occurred in 39 cases and mild exotropia remained in 2 cases in each group. The statistic analyses showed that the surgical results were better in the master eye group in the visual acuity (P < 0.05), visual function (P < 0.05), average surgical amount and frequency (P < 0.01). CONCLUSIONS: The surgical results of strabotomy performed on the master eye in cases with large-angle exotropia are better than that on the slave eye, and the surgical damage in the master eye is less. Thus, the master eye strabotomy is especially suitable for children with large-angle exotropia under general anesthesia.