Drover James R, Stager David R, Morale Sarah E, Leffler Joel N, Birch Eileen E
Retina Foundation of Southwest, Dallas, Texas 75231, USA.
J AAPOS. 2008 Apr;12(2):136-40. doi: 10.1016/j.jaapos.2007.08.013. Epub 2007 Dec 21.
Infantile esotropia is associated with abnormal visual development and thus may delay the achievement of developmental milestones. Although early surgery can improve visual function, less is known about its effect on motor development. Here we address whether early surgery can improve motor development.
Recently, our lab devised the Infant Developmental Skills Survey, a 25-item questionnaire designed to assess sensorimotor and gross motor development. The questionnaire was completed by the parents of 3- to 10-month-old patients with infantile esotropia prior to surgery (n = 143) and the parents of 6- to 11-month-old patients following surgery (n = 58). A subset of parents (n = 40) completed the questionnaire both before and after surgery. For comparison, the questionnaire was completed by the parents of infants with normal ocular alignment (n = 194).
Before surgery 4-, 5-, 6-, 7-, 9-, and 10-month-old patients showed delayed achievement of sensorimotor milestones (p < 0.01), and 5-, 9-, and 10-month-old patients demonstrated delayed attainment of gross motor milestones (p < 0.05) compared with normal children. However, following surgery, patients demonstrated a greater rate of sensorimotor development than age-matched controls (p < 0.0001) and caught up with normal children on both sensorimotor and gross motor skills.
Prior to surgery, patients with infantile esotropia were delayed in their achievement of developmental milestones. However, following surgery, a comparison group of patients showed rapid development and possessed motor skills comparable to those of normal children, suggesting that early surgery is beneficial to both visual and motor development.
婴儿内斜视与视觉发育异常相关,因此可能会延迟发育里程碑的达成。尽管早期手术可以改善视觉功能,但关于其对运动发育的影响知之甚少。在此,我们探讨早期手术是否能改善运动发育。
最近,我们实验室设计了婴儿发育技能调查问卷,这是一份包含25个项目的问卷,旨在评估感觉运动和大运动发育。该问卷由3至10个月大的婴儿内斜视患者术前的父母(n = 143)以及6至11个月大的患者术后的父母(n = 58)完成。一部分父母(n = 40)在手术前后都完成了问卷。作为对照,正常眼位婴儿的父母(n = 194)完成了该问卷。
术前,4、5、6、7、9和10个月大的患者与正常儿童相比,感觉运动里程碑的达成延迟(p < 0.01),5、9和10个月大的患者大运动里程碑的达成延迟(p < 0.05)。然而,术后,患者的感觉运动发育速度比年龄匹配的对照组更快(p < 0.0001),并且在感觉运动和大运动技能方面赶上了正常儿童。
术前,婴儿内斜视患者发育里程碑的达成延迟。然而,术后,一组患者显示出发育迅速,并且具备与正常儿童相当的运动技能,这表明早期手术对视觉和运动发育均有益。