婴儿眼球震颤综合征合并斜视的手术疗效

目的：探讨婴儿眼球震颤综合征（ INS）合并斜视的手术设计及其手术疗效。方法对2011年4月至2012年12月在山东大学附属省立医院眼科中心住院手术治疗的11例INS合并水平性斜视、并符合纳入标准的患儿资料行回顾性分析。手术前后检查患儿的矫正视力、异常头位（ anomalous head postures， AHP）、眼位及立体视锐度。手术设计原则为：在注视眼上设计水平直肌后徙联合截除的手术量以矫正AHP，在非注视眼（斜视眼）上设计水平直肌后徙联合截除的手术量以矫正并存的内斜视或外斜视，且该手术量根据注视眼的手术量进行适当调整。随访时间均≥6个月。结果11例中，合并外斜视6例，内斜视5例；5～15岁，平均（9．0±4．7）岁；平均随访（9．4±5．3）个月。术后5例AHP治愈，6例改善；9例眼位正位，2例欠矫；6例双眼视力增进≥2行，4例双眼视力增进1行，1例双眼视力不变。结论对于INS合并水平性斜视患者，按照在注视眼上设计手术量以矫正AHP、在非注视眼上设计并调整手术量以矫正斜视的原则，可达到矫正AHP和眼位、改善视功能之目的。

Surgical effect of infantile nystagmus syndrome with strabismus

Objective To explore the surgical method and effect of infantile nystagmus syndrome （ INS） with strabis-mus.Methods In this retrospective study, we reviewed 11 cases of INS with strabismus underwent surgeries in the de-partment of ophthalmology of Shandong Provincial Hospital affiliated to Shandong University between April 2011 and December 2012.All children were in accordance with inclusive criteria and with a minimum postoperative follow-up of 6 months.Corrected visual acuity, anomalous head postures（ AHP） , ocular alignment and stereoacuity were examined at both pre-operative and post-operative time.For nystagmus children with strabismus, a recession-resection procedure should be performed on the dominant fixating eye;the amount of recession-resection procedure on the nondominant eye was adjusted to account for the strabismus.Results A total of 11 children with 6 extropic and 5 esotropic were includ-ed.The mean age was 9.0 ±4.7 years （range, 5 to 15 years）.The mean follow-up time was 9.4 ±5.3 months.At last post-operative follow-up time, 5 children of AHP were cured, 9 children of ocular alignment was orthophoria and 2 children were under-corrected;6 children of binocular vision acuity were improved more than 2 levels, and 4 children of binocular vision acuity were improved 1 level, and only one child of binocular vision acuity had no change.Conclusion For INS children with strabismus, surgery should be performed on the dominant fixating eye;surgery on the nondom-inant eye is adjusted to account for strabismus.The surgery is not only to correct AHP and ocular alignment but also to improve binocular vision acuity.