Wu Qi-zhi, Wu Xiao, Lu Wei, Wang Jing-hui
Beijing Tongren Eye Center, Capital University of Medical Sciences, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2007 Nov;43(11):968-71.
To give a suggestion of the timing of surgery, the change of binocular vision before and after strabismus surgery was studied in intermittent exotropia.
One hundred and seventy-one patients, with intermittent exotropia, were divided into 2 groups, based on the age of surgery, Group 1: younger than 9 years of age. Group 2: 9 and older. Binocular vision of both distance and near was checked before and after surgery.
The rebuilding rate of near binocular vision after surgery was: 40.0% for Group 1, 63.8% for Group 2 (P = 0.002), with same onset age (< 4 years), the regain rate of Group 1 was 53.1%, Group 2 was 23.8% (P = 0.032). The distance postoperative binocular vision, using Synoptophore, were: grade I: Group 1 98.2%, Group 2 81.9% (P = 0.027), grade II: Group 1 96.4%, Group 2 84.5% (P = 0.024), grade III: Group 1 81.8%, Group 2 73.3% (P = 0.844). With logistic test, the recovery of binocular vision postoperatively is correlated with preoperative near binocular vision as well as the age of onset (P < 0.01 for both).
The surgery will substantially help to rebuild the binocular vision of both distance and near. The age of onset has significant impact on both the forming and the rebuilding of binocular vision. Operation should not be delayed if onset is younger than 4 years old. Even if the age of onset is older than 4, which is past the critical period of vision development, operative correction no later than 9 is still highly suggested, which may help to rebuild a normal distance binocular vision.
通过研究间歇性外斜视患者斜视手术前后双眼视功能的变化,为手术时机的选择提供建议。
将171例间歇性外斜视患者按手术年龄分为两组,第1组:年龄小于9岁;第2组:年龄9岁及以上。手术前后检查远近双眼视功能。
术后近双眼视功能重建率:第1组为40.0%,第2组为63.8%(P = 0.002);发病年龄相同(<4岁)时,第1组恢复率为53.1%,第2组为23.8%(P = 0.032)。使用同视机检查术后远距离双眼视功能,Ⅰ级:第1组为98.2%,第2组为81.9%(P = 0.027);Ⅱ级:第1组为96.4%,第2组为84.5%(P = 0.024);Ⅲ级:第1组为81.8%,第2组为73.3%(P = 0.844)。经logistic检验,术后双眼视功能恢复与术前近双眼视功能及发病年龄均相关(两者P均<0.01)。
手术对重建远近双眼视功能有显著帮助。发病年龄对双眼视功能的形成和重建均有显著影响。发病年龄小于4岁时手术不应延迟。即使发病年龄大于4岁已过视觉发育关键期,仍强烈建议不迟于9岁进行手术矫正,这可能有助于重建正常的远距离双眼视功能。