【摘要】 目的观察共同性斜视患者手术前后双眼视觉功能的变化,探讨手术年龄与双眼视觉功能恢复的相关性。方法共同性斜视患者37例,同时视、融合功能用同视机检测,立体视采用颜少明编绘的《立体视觉检查图》检测。有屈光不正的患者须戴眼镜矫正后进行检测。记录术前、术后1、3、6个月各项检查数据,按手术年龄分为年龄≤9岁组(16例)和年龄>9岁组(21例),并对数据资料进行统计分析。结果 (1)手术前:两组患者手术年龄、病程的差异有统计学意义(P<0.05);两组斜视度和发病年龄的差异无统计学意义(P>0.05);两组患者的同时视、融合功能及融合范围、立体视的差异无统计学意义(P>0.05)。(2)手术后:①两组间同时视功能的比较:术后1、3、6个月同时视功能两组之间的差异有统计学意义(P<0.05)。年龄≤9岁组同时视功能的恢复明显优于年龄>9岁组。②两组间融合功能及融合范围的比较:术后1个月融合功能及融合范围两组间的差异无统计学意义(P>0.05),术后3、6个月融合功能及融合范围两组间的差异有统计学意义(P<0.05)。年龄≤9岁组在术后3、6个月融合功能的恢复明显优于年龄>9岁组。③两组间立体视功能的比较:术后1、3个月立体视两组间的差异无统计学意义(P>0.05),术后6个月立体视两组间的差异有统计学意义(P<0.05)。年龄≤9岁组在术后6月立体视功能的恢复明显优于年龄>9岁组。④总体手术前后的比较:术后1个月同时视功能较术前有明显恢复(P<0.05),融合功能及融合范围、立体视无明显恢复(P>0.05);术后3、6个月同时视、融合功能及融合范围、立体视均较术前有明显改善(P<0.05)。⑤年龄>9岁组手术前后的比较:术后1、3个月与术前相比视觉三级功能无明显的改善(P>0.05);术后6个月融合范围较术前有显著改善(P<0.05),同时视、立体视较术前无明显改善(P>0.05)。结论①从双眼视觉的恢复和重建及功能治愈来讲,年龄≤9岁组明显优于年龄>9岁组,故共同性斜视患者尽可能在9岁以前手术。②对于视觉发育结束后的患者也应积极治疗,术后双眼视觉功能也能获得一定的改善。③我国斜视患者手术年龄偏大,病程较长,应加强科普宣传,加大全国斜弱视的普查,尽可能做到早发现、早诊断、早治疗。更多还原

【Abstract】 Objective To observe the changes of binocular vision function in comitant strabismus patients before and after surgery.Methods 37 patients with constant comitant strabismus were involved in the study.The simultaneous perception and fusion were examed by synotophore and the stereacuity was examed by Shaoming Yan’s stereogram.The patients who have ametropia must wear rectified glasses when examing.Record above examination datas before surgery and one month,three months,six months after surgery.The patients were divided into two groups,16 cases in the≤9 years of age group and 21cases in the>9 years of age group.This study based on these datas.Results(1)Preoperative:The differences had statistical significance in the operation age and course(P<0.05),no statistical significance in the onset age,the degree of deviation,simultaneous perception,fusion and range of fusion,stereacuity(P>0.05).(2)Postoperative:Comparation between the two groups,the differences had statistical significance in the simultaneous perception at one month,three months,six months after surgery(P<0.05).At one month after surgery the differences had no statistical significance in the fusion and range of fusion(P>0.05);At three months and six months after surgery the differences had statistical significance in the fusion and range of fusion(P<0.05).The differences had no statistical significance in the stereacuity at one month and three months after surgery(P>0.05);The differences had statistical significance in the stereacuity at six months after surgery(P<0.05).37 cases after surgery compared with before surgery,the difference had statistical significance in the simultaneous perception at one month after surgery(P<0.05),no statistical significance in the fusion and range of fusion,stereacuity(P>0.05);The differences had statistical significance in the simultaneous perception,fusion and range of fusion,stereacuity at three months and six months after surgery(P<0.05).Cases in the >9 years of age group after surgery compared with before surgery: The differences had no statistical significance in the function of vision at one month and three months after surgery(P>0.05);The differences had statistical significance in the range of fusion at six months after surgery(P<0.05),no statistical significance in the simultaneous perception and stereacuity at six months after surgery(P>0.05).Conclusion ①According to the recovery and rebuilding of binocular vision function,the operation for patients with comitant strabismus should be taken before 9 years old.②Active treatment also should be taken for the patients whose binocular vision function have matured.They also can get some extent recovery and rebuilding of binocular vision function.③Patients with constant comitant strabismus in China have older operation age and longer course.It should be necessary to enhance science education publicize,enlarge extensive survey of strabismus and amblyopia nationally,and make early detection,early diagnosis,early treatment as far as possible.更多还原