36例儿童先天性内斜视手术治疗探讨

目的:探讨先天性内斜视的手术时机、手术方法及手术效果.方法:回顾性分析手术治疗的先天性内斜视36例.内斜视20△单眼内直肌后徙5 mm;+40△～60△双眼内直肌后徙4～6 mm;少数大龄患儿且斜视角较大者采用双眼内直肌后徙加单眼外直肌截除术.术后同视机训练三级功能.结果:术后眼位正位28例,欠矫7例,过矫1例.术前斜视角在+30△～+50△,术后眼位正位率91.67%(33/36);术前斜视角大于+50△,术后眼位正位率61.11%(22/36).结论:先天性内斜视患儿应早期手术治疗,双眼内直肌后徙术为首选术式,术后的随访对于远期眼位正位非常重要.

Surgical treatment of 36 cases of children's congenital esotropia

Objective：To investigate the time,methods and results of the surgery of congenital esotropia.Methods：Retrospective analysis was made of surgical treatment of 36 cases of congenital esotropia.For 20△ monocular esotropia,the inner rectus was resettled backward for 5 mm;for ＋40△ ~ 60△the inner rectus of both eyes were resettled backward for 4 ~ 6 mm;a small number of older children with greater squinting were treated with the inner rectus resettled backward in both their eyes plus the treatment of cutting the external rectus away directly.After treatment,three-level-function training was carried out on synoptophore.Results：28 patients＇ eye positions were corrected after orthotopic,7 cases undercorrection,and 1 case overcorrection.For those with preoperative oblique angle at ＋30△ ~ ＋50△,the orthotopic rate of the eye position was 91.67%（33/36）;for those with preoperative squinting angle greater than ＋50△,the orthotopic rate of the eye position was 61.11%（22/36）.Conclusion：The surgery of children with congenital esotropia should be done early,with the downward rectus resettlement within eyes as the preferred surgical technique.The postoperative follow-up is very important for the long term eye position correction.