知觉学习训练重建共同性外斜视术后立体视功能的作用

摘要

Objective:To observe the effect of perceptual learning in reconstructing stereopsis of postoperative comitant exotropia.Methods:In this prospective study,23 postoperative exotropic patients who underwent surgery from August 2009 to August 2011 at the First Affiliated Hospital of Anhui Medical University were recruited.By three months after surgery,all patients were aligned but did not achieve normal stereopsis when examined by the Titmus stereo test.Patients were trained by a perceptual learning method based on disparity discrimination.Disparity discriminating accuracy and stereoacuity were measured beforeand after training.The data were analyzed using paired t-test.Results:Two patients were excluded due to poor fusion.The average training time was 6.9 ± 3.8 days.After training,stereoacuity was significantly improved in all 21 patients (t=8.228,P＜0.001).The disparity discriminating accuracy test showed that under disparities of 320″,440″,and 580″,the accuracies were improved after training (t=-3.102,P=0.01;t=-2.360,P=0.02;t=-2.177,P=0.03 respectively).Conclusions:Perceptual learning can be used in reconstructing stereopsis for postoperative exotropic patients,and the effect can be maintained.However,the exact mechanism by which the reconstruction of stereopsis occurs need further research.%目的:采用知觉学习训练方法对斜视矫正术后无立体视功能或者立体视功能不能恢复至正常的共同性外斜视患者进行训练,探讨知觉学习训练在斜视术后立体视功能重建中的作用.方法:前瞻性研究.选择2009年8月至2011年8月在安徽医科大学第一附属医院行斜视矫正术后眼位正位的共同性外斜视患者23例,均为术后3个月以上Titmus立体图检查立体视功能未达到正常者.采用心理物理学中的知觉学习方法进行立体视功能训练,观察训练前后视差辨别正确率、立体视锐度的变化.训练前后的数据比较采用配对t检验.结果:23例患者中有2例不能完成训练任务,21例患者顺利完成训练,平均训练(6.9±3.8)d,经知觉学习训练后立体视功能较训练前明显改善,差异具有统计学意义(t=8.228,P＜0.001).视差辨别正确率检测显示,受试者在视差分别为320″、440″、580″时,训练后应答正确率高于训练前应答正确率,差异均具有统计学意义(t=-3.102,P=0.01;t=-2.360,P=0.02;t=-2.177,P=0.03).结论:知觉学习训练可有效重建共同性外斜视术后患者的立体视功能,但具体机制有待进一步研究.