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目的探讨间歇性外斜视患者手术矫正前、后的双眼融合功能和立体视锐度改善情况。方法选择2010年10月至2015年10月眼科行矫正手术眼位正位的118例间歇性外斜视患者作为研究对象,根据患者术后不同眼位将其分为Ⅰ组(+1~+5 PD)、Ⅱ组(0 PD)、Ⅲ组(-1~-5 PD)及Ⅳ组(-6~-10 PD)。运用Titmus立体视图对患者看近的立体视锐度进行测定分析,采用手电筒式Worth四点灯对患者的中心融合以及周边融合功能进行检查。比较手术矫正前、后的双眼融合功能、立体视锐度。结果术前中心融合、周边融合、无融合患者占比分别为20.34%、34.75%、44.92%;术后中心融合、周边融合、无融合患者占比分别为68.64%、19.49%、11.86%,手术前后双眼融合功能相比,差异有统计学意义(Z=45.201,P<0.01);术后不同眼位4组患者间的双眼融合功能存在显著差异(Z=18.182,P<0.01),中心融合患者占比情况为:Ⅱ组>Ⅲ组>Ⅳ组>Ⅰ组;除Ⅰ组外,Ⅱ、Ⅲ、Ⅳ组患者手术前后立体视锐度比较差异均有统计学意义(P均<0.01)。结论大部分间歇性外斜视患者行矫正手术后,其双眼融合功能均显著改善,且大部分患者立体视锐度明显提高;但术后仍然存在持续性小度数内斜视(5 PD以下)的患者,立体视锐度较术前无差异,表明术后长期小度数过矫会对立体视功能产生影响。
Objective To investigate the improvement of the fusion of both eyes and stereoacuity before and after surgical correction of intermittent exotropia. Methods A total of 118 patients with intermittent exotropia underwent ophthalmic orthopedic surgery from October 2010 to October 2015 were enrolled in this study. Patients were divided into group Ⅰ (+ 1 ~ + 5 PD), group Ⅱ (0 PD), group Ⅲ (-1 ~ 5 PD) and group Ⅳ (-6 ~ -10 PD). Using the Titmus stereoscopic view of the patient to see near stereoacuity determination analysis, the use of a flashlight Worth four lights on the patient’s central fusion and peripheral fusion function to be checked. Comparison of surgery before and after the binocular fusion function, stereopsis sharpness. Results The proportion of patients with central fusion, peripheral fusion and non-fusion before operation was 20.34%, 34.75% and 44.92% respectively. The proportion of patients with central fusion, peripheral fusion and non-fusion were 68.64%, 19.49% and 11.86% There was significant difference in the fusion function between the two groups (Z = 18.182, P <0.01). The central fusion was significantly different between the two groups (Z = 45.201, P <0.01) The proportions of patients were as follows: group Ⅱ> group Ⅲ> group Ⅳ> group Ⅰ; except for group Ⅰ, there was significant difference in stereopsis before and after operation between group Ⅱ, Ⅲ and Ⅳ (all P <0.01). Conclusions Most patients with intermittent exotropia have significantly improved their fusion function after orthodontic surgery, and most of them have significantly improved their stereopsis. However, patients with persistent small exotropia (below 5 PD) Stereoscopic sharpness no difference compared with preoperative, indicating that long-term small degree of over-correction of stereo vision function will have an impact.