Wang Yuan, Wu Qian, Bai Dayong, Cao Wenhong, Cui Yanhui, Fan Yunwei, Hu Shoulong, Yu Gang
National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China; Email:
Zhonghua Yan Ke Za Zhi. 2015 Nov;51(11):844-9.
To evaluate the efficacy of surgery in the treatment of congenital nystagmus with convergence damping.
Retrospective and comparative case series. Eight patients diagnosed as congenital nystagmus with convergence damping at Beijing Children's Hospital between September 2010 and September 2012 were enrolled in this study. The ages were 9.5 (12, 6) years old, and follow-up was 9 (24, 6) months. All patients received prism induced convergence and the same surgery of bimedial rectus recession and bilateral rectus tenotomy. The best corrected visual acuity, the range of fusion and the nystagmus waveforms were analyzed before and after surgery.
The range of fusion was -3.75±1.83° to +19.38±3.16° before surgery and -3.88±1.55° to +19.00±3.02° after surgery; there was no significant difference (t=0.24, P=0.82). The binocular visual acuity increased from 0.21±0.15 without convergence to 0.28±0.18 using convergence; there was significant difference (t=-4.43, P=0.00). The visual acuity was 0.32±0.20 after surgery, significantly different from that before surgery without convergence (t=-5.29, P=0.00), but not significantly different from that before surgery using convergence (t=-2.12, P=0.07). Patients had significant improvements in the frequency (t=3.28, 3.02, P<0.05) and intensity of the nystagmus waveforms when using convergence and postoperatively (t=3.27, 3.48; P<0.05), but there was no significant improvement in the amplitude of the waveforms (t=1.31, 1.57, 0.31, P>0.05).
Surgery for congenital nystagmus with convergence damping can provide expectations for ocular motor and visual results. The range of fusion should be wide enough, and the effect of convergence on the frequency is greater than that on the amplitude.
评估手术治疗伴有集合阻滞的先天性眼球震颤的疗效。
回顾性比较病例系列研究。选取2010年9月至2012年9月在北京儿童医院诊断为伴有集合阻滞的先天性眼球震颤的8例患者。年龄为9.5（12，6）岁，随访时间为9（24，6）个月。所有患者均接受棱镜诱导集合以及相同的双眼内直肌后徙和双侧直肌断腱手术。分析手术前后的最佳矫正视力、融合范围和眼球震颤波形。
手术前融合范围为-3.75±1.83°至+19.38±3.16°，手术后为-3.88±1.55°至+19.00±3.02°；差异无统计学意义（t=0.24，P=0.82）。双眼视力从集合前的0.21±0.15提高到集合时的0.28±0.18；差异有统计学意义（t=-4.43，P=0.00）。术后视力为0.32±0.20，与集合前手术前相比差异有统计学意义（t=-5.29，P=0.00），但与集合时手术前相比差异无统计学意义（t=-2.12，P=0.07）。患者在集合时和术后眼球震颤波形的频率（t=3.28，3.02，P<0.05）和强度（t=3.27，3.48；P<0.05）有显著改善，但波形幅度无显著改善（t=1.31，1.57，0.31，P>0.05）。
伴有集合阻滞的先天性眼球震颤手术可改善眼球运动和视觉效果。融合范围应足够宽，集合对频率的影响大于对幅度的影响。
