摘要：
· AIM:To analyze the clinical features of binocular visual function in children with intermittent exotropia before and after operation,so as to provide theoretical basis for surgical treatment of intermittent exotropia.· METHODS:Enrolled forty patients with intermittent exotropia in our hospital from January 2016 to January 2017,in which 64 eyes received operation.All patients underwent surgical treatment and were followed up for 6wk,to compare the proportion of patients with Ⅰ,Ⅱ and Ⅲ of visual function before and after the treatment.Seeing WORTH four hole lamp near and far respectively were used to compare central and peripheral fusion before and at 2wk and 6wk after operation.Yan's random dot stereogram (Stereoscopic Test Charts,STC) was used to evaluate the near stereopsis,and synoptophore (STC) picture for distant stereopsis evaluation before and at 2wk and 6wk after operation.· RESULTS:There were 26 cases (65％),9 cases (22.5％),5 cases (12.5％) with preoperative vision function of Ⅰ,Ⅱ and Ⅲ respectively;10 cases (25％),17 cases (42.5％) and 13 cases (32.5％) at 2wk after operation;8 cases (20％),18 cases (45％),14 cases (35％) at 6wk after surgery;the differences between the proportion before and 2wk after operation,before and 6wk after operation were significant (P＜0.05).WORTH four hole lamp examination showed preoperative proportion of patients with central fusion was significantly lower than that at 2wk and 6wk after surgery;the proportion at 2wk was significantly lower than that at 6wk after surgery,the difference was statistically significant (P＜0.05).The proportion of patients with peripheral fusion at 2 and 6wk after operation was significantly higher than that before operation (P＜ 0.05),but the proportion at 2wk was not different from 6wk (P＞0.05).The near stereopsis at 2 and 6wk after operation was significantly improved than that before operation (P＜ 0.05),but that at 2wk was not different from 6wk (P＞ 0.05).The proportion of patients with distant stereopsis at 2wk (24 cases,60％) and 6wk (39 cases,97.5％) after operation was significantly higher than that before operation (6 cases,15％,P＜0.05),but the proportion at 2wk was not different from 6wk (P＞0.05).· CONCLUSION:Intermittent exotropia correction surgery can significantly improve the binocular single vision and save the deterioration of patients with far,near stereopsis and central fusion.%目的:对间歇性外斜视儿童手术前后双眼单视功能进行临床分析,为间歇性外斜视的手术治疗提供理论依据.方法:选取对象为2016-01/2017-01于我院斜视与小儿眼科治疗的间歇性外斜视儿童患者40例,40例患者中手术眼为64眼.所有患者均采用斜视矫正手术治疗,术后随访6wk,比较治疗前后存在Ⅰ、Ⅱ、Ⅲ级视功能人数比例,采用视近、视远WORTH四孔灯分别对患者术前和术后2、6wk的中央及周边融合情况进行比较,采用颜少明颜氏随机点立体图(stereoscopic test charts,STC)评价术前和术后2、6wk近立体视,采用同视机画片对患者术前、术后2、6wk的远立体视进行评估.结果:视功能Ⅰ、Ⅱ、Ⅲ级术前人数分别为26例(65％)、9例(22.5％)、5例(12.5％),术后2wk分别为10例(25％)、17例(42.5％)、13例(32.5％),术后6wk分别为8例(20％)、18例(45％)、14例(35％),术前与术后2、6wk比较差异具有统计学意义(P＜0.05),术后2wk和6wk比较差异无统计学意义(P＞0.05);WORTH四孔灯检查结果显示术前中央融合人数比例显著低于术后2、6wk,术后6wk中央融合人数显著高于术后2wk人数,差异具有统计学意义(P＜O.05);术后2、6wk周边融合人数显著高于术前,差异具有统计学意义(P＜0.05),术后2、6wk比较差异无统计学意义(P＞0.05);术后2、6wk近立体视较术前显著改善,差异具有统计学意义(P＜0.05),术后2、6wk比较差异无统计学意义(P＞0.05);术后2、6wk远立体视人数比例分别为24例(60％)与39例(97.5％),较术前6例(15％)显著改善,差异具有统计学意义(P＜0.05),术后2、6wk比较差异无统计学意义(P＞0.05).结论:间歇性外斜视儿童行矫正手术能显著改善双眼单视功能,挽救患者的远、近立体视以及中央融合功能.
