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目的观察先天性内斜视的临床特征和疗效,探讨早期治疗的意义。方法统计228例先天性内斜视病例,对其临床特征和术后远期观察结果进行回顾分析。结果(1)先天性内斜视伴有弱视、下斜肌功能亢进(IOOA)和垂直分离性斜视(DVD)的比率较高,斜视角大且稳定,绝大多数以非调节性因素为主。(2)远期正位率明显低于术后正位率,～2岁组远期正位率明显低于～4岁组与～8岁组,～4岁组术后建立融合功能的比率最高。结论(1)先天性内斜视主要危害是双眼单视功能的缺陷和弱视,应早期手术,4岁前手术可能获得双眼单视功能。(2)伴随体征如DVD,IOOA可影响远期眼位,如有手术指征应与内斜视同时矫正,术后出现也应及时处理。少数患儿存在调节性因素。
Objective To observe the clinical features and efficacy of congenital esotropia and to explore the significance of early treatment. Methods A total of 228 cases of congenital esotropia were retrospectively analyzed. The clinical features and long-term postoperative observation were retrospectively analyzed. Results (1) Congenital esotropia with amblyopia, inferior oblique muscular function (IOOA) and vertical separation strabismus (DVD) a higher rate of strabismus angle and stability, the vast majority of non-regulatory factors. (2) The long-term positive rate was significantly lower than the postoperative positive rate, long-term positive rate in ~ 2 years old group was significantly lower than that of ~ 4 years old group and ~ 8 years old group, ~ 4 years old group postoperative fusion function ratio highest. Conclusion (1) The main hazard of congenital esotropia is the binocular vision defects and amblyopia, should be early surgery, surgery may get binocular vision function before the age of 4 years. (2) accompanied by signs such as DVD, IOOA can affect the long-term eye position, if any indications for surgery should be corrected with esotropia, postoperative should also be promptly addressed. A few children have regulatory factors.