儿童先天性上斜肌麻痹术后双眼视功能的变化

目的:通过对儿童先天性上斜肌麻痹手术前后双眼视功能的观察,探讨其术后成功重建双眼视觉的影响因素。方法:对30例34眼接受手术治疗的儿童先天性上斜肌麻痹患者进行回顾性分析,所有患者手术前后均用同视机检查双眼视功能,Titmus(立体视检查图)检查近立体视觉。结果:手术后同时知觉、融合功能、远立体视、近立体视较术前均有明显改善,有统计学差异(P<0.05);比较不同视力手术后立体视的变化情况,发现好视力组术后立体视恢复较差视力组好,两者比较有统计学差异(P<0.05);不同斜视度数术后立体视改善情况不同,大度数组术后立体视恢复较小度数组差,两者比较有统计学差异(P<0.05)。比较有无代偿头位,发现有代偿头位组术后立体视好于无代偿头位组,两者有统计学差异(P<0.05)。结论:儿童先天性上斜肌麻痹术后双眼视功能明显改善,视力、斜视度、代偿头位对术后双眼视觉重建均有影响。

Postoperative change of binocular vision in children with congenital superior oblique palsy

AIM: To explore the influencing factors of rebuilding binocular vision after surgery through comparison of preoperative and postoperative binocular vision in children with congenital superior oblique palsy.

METHODS: Totally 30 congenital superior oblique palsy children(34 eyes)accepted surgery were analyzed retrospectively. Before and after surgery, binocular vision in children was evaluated by synoptophore and stereoacuity was examined by Titmus.

RESULTS: Postoperative simultaneous perception, fusion, distance or near stereoacuity were better than preoperative. There was statistically significant difference(P<0.05). Comparing the groups with different visual acuity, the better stereoacuity recovery in the group with better visual acuity was found(P<0.05). The difference had statistically significance. The improvement of stereoacuity at high dimensionality group was worse than the low. Stereoacuity in group with compensatory head position was better. The difference had statistical significance(P<0.05).

CONCLUSION: Surgery is the reasonable choice for the children with congenital superior oblique palsy. Visual acuity and strabismus degrees and compensatory head position are influencing factors of rebuilding binocular vision.