Scott W E, Kutschke P J, Lee W R
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, USA.
J Pediatr Ophthalmol Strabismus. 1995 Nov-Dec;32(6):348-52. doi: 10.3928/0191-3913-19951101-05.
A retrospective analysis of adults with strabismus was done to examine the potential risks and the possible benefits of surgical treatment and to describe the types of adult strabismus.
Eight hundred ninety-two patients were analyzed. Age at time of surgery ranged from 9 years to 89 years. The average follow up was 34 months. Major types of strabismus were grouped by their original diagnoses. The group of patients with horizontal strabismus, which usually had an onset before 9, was termed the before visual maturity (BVM) group. The group of patients with paretic or restrictive strabismus usually had the onset of strabismus after age 9 and was termed the after visual maturity (AVM) group.
Patients with adult strabismus can gain restoration of alignment, as well as binocular function. At the last postoperative visit, 74% of the BVM group were aligned within 15 prism diopters. Not only was restoration of alignment accomplished, many of them gained some degree of sensory fusion as measured by the Worth 4-Dot (W4D) or Titmus stereoacuity. Twenty-nine percent of patients with congenital esotropia had some sensory fusion. The other subtypes in the BVM group had even higher percentages of patients with postoperative stereoacuity. In the AVM group, 92% had fusion at the last postoperative visit.
The outcomes of adult strabismics in our study show that certain benefits can be gained from correction of ocular alignment. Restoration of alignment, elimination of diplopia and sensory fusion are functional benefits that can be obtained through strabismus surgery in the adult patient. It is clear that adult strabismus is more than just a cosmetic problem and treatment is worthwhile.
对成人斜视患者进行回顾性分析，以研究手术治疗的潜在风险和可能的益处，并描述成人斜视的类型。
分析了892例患者。手术时年龄从9岁至89岁不等。平均随访时间为34个月。主要斜视类型根据其初始诊断进行分组。水平斜视患者组，其斜视通常在9岁之前发病，被称为视觉成熟前（BVM）组。麻痹性或限制性斜视患者组，其斜视通常在9岁之后发病，被称为视觉成熟后（AVM）组。
成人斜视患者可实现眼位矫正以及双眼功能恢复。在术后最后一次随访时，BVM组中74%的患者眼位偏差在15棱镜度以内。不仅实现了眼位矫正，通过Worth 4 - Dot（W4D）或Titmus立体视锐度测量，许多患者还获得了一定程度的感觉融合。29%的先天性内斜视患者有一定的感觉融合。BVM组中的其他亚型术后立体视的患者百分比更高。在AVM组中，92%的患者在术后最后一次随访时有融合功能。
我们研究中成人斜视患者的治疗结果表明，矫正眼位可带来一定益处。眼位矫正、消除复视和感觉融合是成人患者通过斜视手术可获得的功能益处。显然，成人斜视不仅仅是一个美容问题，治疗是值得的。
