Morris R J, Scott W E, Dickey C F
Southampton Eye Hospital, England.
Ophthalmology. 1993 Jan;100(1):135-8. doi: 10.1016/s0161-6420(93)31703-3.
Fusion and the development of the monofixation syndrome are well recognized after surgical alignment of congenital esotropia to within 8 delta of orthotropia. However, in adults with longstanding strabismus and a history of congenital esotropia who are not surgically aligned within the first few years of life, the prognosis for the development of fusion is believed to be poor.
Twenty-four adults, 12 with a history of congenital esotropia (onset before 6 months age), 1 of congenital exotropia, and 11 with the onset of esotropia between 6 months and 2 years, were included in this study. All patients had longstanding strabismus, and none had been surgically aligned within the first 2 years of life. No patient had visual acuity worse than 20/30 in the worse eye. Preoperatively, no patient demonstrated fusion with the red glass test, Worth four-dot, or Titmus test. Postoperatively, all were aligned to within 8 delta of orthotropia, and all demonstrated peripheral fusion with the Worth four-dot at near. Twelve patients (50%), 8 of whom were in the congenital group, achieved stereopsis of 200 seconds of arc or better using the Titmus stereo test.
These findings suggest that surgery in this group of patients not only eliminates the ocular alignment deformity but can confer the functional benefits of fusion and increased field of binocular vision.
先天性内斜视手术矫正至正交位8棱镜度以内后，融合及单眼注视综合征的发生已得到充分认识。然而，对于那些在生命最初几年未接受手术矫正、患有长期斜视且有先天性内斜视病史的成年人，融合发展的预后被认为较差。
本研究纳入了24名成年人，其中12名有先天性内斜视病史（发病年龄在6个月之前），1名有先天性外斜视病史，11名斜视发病年龄在6个月至2岁之间。所有患者均有长期斜视，且在生命的前2年都未接受过手术矫正。所有患者较差眼的视力均不低于20/30。术前，没有患者通过红玻璃试验、Worth四点试验或Titmus试验表现出融合。术后，所有患者均矫正至正交位8棱镜度以内，并且所有患者在近距离通过Worth四点试验表现出周边融合。12名患者（50%），其中8名属于先天性组，使用Titmus立体视试验获得了200角秒或更好的立体视。
这些发现表明，对这组患者进行手术不仅消除了眼位不正畸形，还能带来融合以及扩大双眼视野的功能益处。
