Stangler-Zuschrott E
Klin Monbl Augenheilkd. 1982 Nov;181(5):397-9. doi: 10.1055/s-2008-1055256.
Since it is well known that the eye musculature undergoes degenerative alterations in old age, the question arises whether squint operations are effective in presbyopic and elderly persons. Twenty-four patients with horizontal squint (average age 63 years) wanted the operation because of diplopia, asthenopia and, in a few cases, for cosmetic reasons; 5 patients were aphakic. The operation was successful in 20 cases. The principles of dosing the operation are essentially the same as for juvenile patients. However, specific difficulties in treating elderly patients arise from: (1) lack of accommodative convergence, as a result of which the squint angle difference between distance and near fixation is usually greater; (2) increasing rigidity of the eye muscles, which diminishes the range of fusion; as a result, the patient is unable spontaneously to compensate for minor squint deviations; (3) senile organic lesions of the bulbs further impair fusion. It is advisable to treat convergent squint by correcting the average deviation between distance and near fixation, preferably shortening the external recti. Cases of divergent squint should preferably be treated by correcting the smaller squint angle, with resection of the external recti. The older the patient is and the worse his fusion, the more precisely the operation has to be dosed. Orthoptic training helps in old patients too.
由于众所周知眼肌组织在老年时会发生退行性改变，因此就出现了斜视手术对老花眼和老年人是否有效的问题。24例水平斜视患者（平均年龄63岁）因复视、视疲劳，少数情况下是出于美容原因而希望接受手术；5例患者无晶状体。手术成功20例。手术剂量的原则与青少年患者基本相同。然而，治疗老年患者存在一些特殊困难，原因如下：（1）缺乏调节性集合，因此远距离和近距离注视时的斜视角度差异通常更大；（2）眼肌的僵硬程度增加，这会减少融合范围；结果，患者无法自发地代偿轻微的斜视偏差；（3）眼球的老年性器质性病变会进一步损害融合功能。对于会聚性斜视，建议通过纠正远距离和近距离注视之间的平均偏差来治疗，最好缩短外直肌。对于散开性斜视，最好通过纠正较小的斜视角度来治疗，即切除外直肌。患者年龄越大，融合功能越差，手术剂量就必须越精确。正位视训练对老年患者也有帮助。
