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目的了解V型斜视的病因、临床表现、手术方法及疗效。方法分析1998年3月至2004年12月笔者对777例水平斜视手术中48例V型斜视的治疗结果。48例V型斜视年龄最小5岁,最大26岁,5-14岁25 例,15-26岁23例,男29例,所有病例均用三棱镜或同视机检查九个方位斜视角,所有病例均伴有单眼或双眼下斜肌功能亢进。43例眼底照像检查除5例7眼未查出外旋外,余均为外旋。同视机检查均无双眼单视功能。均行单眼或双眼下斜肌后徙或前转位术,同时行单眼或双眼内外直肌后徙和/或缩短术矫正内外斜视。术后随访时间 1-24月,平均10月。结果 V型斜视占水平斜视的6．17％。引起V型斜视的常见原因为斜肌功能异常,包括原发性下斜肌功能亢进28例(58％),先天性上斜肌麻痹20例(42％)。手术治疗1例欠矫外,余均正位,98％,获得满意效果。22例(45．8％)获双眼单视功能。结论 V型斜视是一种常见的斜视类型,发病原因以斜肌功能异常为主,常合并水平斜视,V型外斜多于V型内斜,斜肌手术是矫正V型斜视的主要措施之一。
Objective To understand the etiology, clinical manifestations, surgical methods and curative effects of V-type strabismus. Methods From March 1998 to December 2004, the author analyzed the results of 48 cases of type V strabismus in 777 horizontal strabismus surgery. Forty-eight cases of type V strabismus had the youngest 5 years old, the oldest was 26 years old, the other was 25 years old and 5-14 years old, 23 cases were 15-26 years old and 29 were males. All the cases were examined by prism or synoptophore. Are associated with monocular or binocular oblique function hyperthyroidism. 43 cases of fundus photography in addition to 5 cases of 7 cases did not detect the external rotation, I were outside rotation. With the same binocular examination binocular vision function. All underwent monocular or binocular oblique back muscle or anterior transposition, at the same time, monocular or binocular rectus muscle and / or shortening correction of internal and external strabismus. Follow-up time 1-24 months, an average of 10 months. Results V-strabismus accounted for 6.17% of horizontal strabismus. Common causes of V-type strabismus are dysplasia of the oblique muscles, including 28 cases (58%) of primary hypopyxia and 20 cases (42%) of congenital superior oblique palsy. Surgical treatment of one case of undercorrection, the more are positive, 98%, access to satisfactory results. Twenty-two patients (45.8%) had monocular visual function. Conclusions V-type strabismus is a common type of strabismus. The main cause of the disease is dysplasia of oblique strabismus, which is often associated with horizontal strabismus. V-shaped exotropia is more than V-type obliquity, and oblique operation is the main measure to correct V-type strabismus. one.