压贴三棱镜治疗儿童间歇性外斜视术后过矫的临床疗效

doi:10.3760/cma.j.cn115909-20200709-00292

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摘要目的：探讨压贴三棱镜治疗4～8岁儿童间歇性外斜视术后过矫导致的继发性内斜视的临床疗效。方法：回顾性临床研究。收集2017年1─12月于济南市第二人民医院行斜视矫正术且术后2个月确定存在过矫（+5△<斜视度≤+25△）的间歇性外斜视患者38例，年龄4～8岁，配戴压贴三棱镜，度数为1/3～1/2的残余内斜视，每2个月复查，根据眼位情况调整压贴三棱镜度数，斜视度≤+5△并稳定3个月后可去除压贴三棱镜。自使用压贴三棱镜起随诊1年观察眼位正位率（百分比）、斜视度、远近立体视觉。各时间点的数据比较采用方差分析和χ2检验。结果：压贴三棱镜治疗2个月正位率为5%（2/38），治疗6个月正位率为45%（17/38），治疗1年正位率为71%（27/38）。压贴三棱镜治疗6个月后近立体视正常率较戴镜前提高（χ2=3.75，P=0.029）。压贴三棱镜治疗1年后近立体视和远立体视正常率较治疗前明显提高（χ2=14.53，P=0.025；χ2=15.57，P=0．022）。结论：4～8岁间歇性外斜视儿童术后出现>+5△～≤+25△的内斜视时，使用压贴三棱镜有助于眼位及立体视功能的恢复。

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关键词 ：间歇性外斜视, 过矫, 正位率, 立体视觉, 压贴三棱镜

Abstract： Objective: To study the treatment of secondary esotropia caused by overcorrection of intermittent exotropia in children aged 4-8 years using a press-on prism, and its effect of press-on prism. Methods: In this retrospective study, 38 patients with overcorrection (+5△<strabismus≤25△) 2 months after surgery, aged 4 to 8 years with intermittent exotropia who were treated in the Eye Center of the Second People's Hospital of Ji'nan from July to December 2017 were included. In 38 cases, 1/3 to 1/2 of the residual esotropia was corrected by using a press-on prism. Patients were reviewed every 2 months and the degree of the press-on prism was adjusted according to the eye position. The press-on prism was removed when squint was ≤+5△ and stable after 3 months. Patients were followed up for one year after press-on prism treatment, to observe orthotropism rate (percentage), and far and near stereoscopic vision (median). At each time point, analysis of variance and χ2 tests were used to compare the data. Results: The orthotopic rate 2 months after the treatment was 5%(2/38), and was 45%(17/38) 6 months after the treatment. The orthotopic rate was 71%(27/38) 1 year after the treatment. The normal rate of near stereoscopic vision was significantly higher 6 months after the treatment compared to before treatment (χ2 =3.75, P=0.029).The normal rates of near stereoscopic and far stereoscopic vision was significantly higher 1 year after the treantment compared to before treatment (χ2 =14.53, P=0.025; χ2 =15.57, P=0.022). Conclusions: In overcorrected children with intermittent exotropia aged 4-8 years, wearing a press-on prism can help restore the ocular position and stereoscopic vision function.

Key words： intermittent exotropia overcorrection orthotopic rate stereoscopic vision press-on prism

收稿日期: 2020-07-09

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通讯作者: 尹晓琳（ORCID：0000-0002-9231-6613），Email：yinxiaolin918@163.com

引用本文:

杨珺张颖尹晓琳. 压贴三棱镜治疗儿童间歇性外斜视术后过矫的临床疗效[J]. 中华眼视光学与视觉科学杂志, 2021, 23(5): 369-373. Jun Yang, Ying Zhang, Xiaolin Yin. Observation of the Effect of a Press-on Prism on Overcorrected Cases after Intermittent Exotropia Surgery in Children. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(5): 369-373. DOI: 10.3760/cma.j.cn115909-20200709-00292

链接本文:

https://www.cjoovs.com/CN/ 10.3760/cma.j.cn115909-20200709-00292 或 https://www.cjoovs.com/CN/Y2021/V23/I5/369

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