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[早期手术治疗婴儿型内斜视对双眼视觉质量的影响]

[Effect of early surgery in essential infantile esotropia on the quality of binocular vision].

作者信息

Autrata R, Hromádková L, Rehůrek J

机构信息

Dĕtská ocní klinika DN FNB a LF MU, Brno.

出版信息

Cesk Slov Oftalmol. 2002 Jan;58(1):36-41.

Abstract

In a retrospective study of 397 children operated in the course of 10 years (1985-1995) on account of essential infantile esotropia the authors evaluate the effect of early surgery implemented before the age of two years on the quality of binocular vision as compared with a later operation. The group of children was divided into three sub-groups. Group A comprised 75 children with the operation during the first six months of life (mean 3.8 months), sub-group B 194 children with the operation at the age of 6-24 months and in group C 128 children operated at the age of 2-6 years (mean 3.56 years). In group A binocular vision was recorded in 80% children (15% superposition, 60% fusion, 5% stereopsy). In groups B binocular vision was recorded in 76% children (18% superposition, 50% fusion, 8% stereopsy). In group C simple binocular vision in the form of superposition was present in 24% and fusion only in 21% children. The results of binocular vision after surgery of essential infantile esotropia are in favour of early surgery, preferably by the age of 6 months, not later than at the age of 2 years. An essential part of comprehensive treatment is active and positive pleoptic and orthoptic care incl. supplementary surgical correction of residual horizontal or vertical deviations. Early surgery of an adequate extent with a safeguarded parallel position of the eyes implies in the long run more frequent achievement of a higher quality of binocular vision incl. stereopsy.

摘要

在一项对10年间(1985 - 1995年)因原发性婴儿型内斜视接受手术的397例儿童的回顾性研究中,作者评估了两岁前进行的早期手术与较晚手术相比,对双眼视觉质量的影响。将儿童组分为三个亚组。A组包括75例在出生后头六个月内接受手术的儿童(平均3.8个月),B亚组有194例在6至24个月龄接受手术的儿童,C组有128例在2至6岁(平均3.56岁)接受手术的儿童。A组中80%的儿童记录到双眼视觉(15%为叠加,60%为融合,5%为立体视)。B组中76%的儿童记录到双眼视觉(18%为叠加,50%为融合,8%为立体视)。C组中,24%的儿童存在叠加形式的简单双眼视觉,仅21%的儿童有融合。原发性婴儿型内斜视手术后的双眼视觉结果支持早期手术,最好在6个月龄前,最迟不超过2岁。综合治疗的一个重要部分是积极且正向的弱视治疗和视轴矫正训练,包括对残余水平或垂直偏差的补充手术矫正。从长远来看,进行足够范围的早期手术并保证眼睛平行位置,更常能实现更高质量的双眼视觉,包括立体视。

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