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目的探讨异常及和谐异常视网膜对应共同性内斜视在手术方法、手术量、手术后双眼视觉的变化,以及手术量对手术成功率的影响。设计回顾性病例系列。研究对象20例异常及和谐异常视网膜对应的内斜视患者。方法分析北京大学眼科中心1年内收治20例异常及和谐异常视网膜对应的内斜视患者。手术前常规进行眼科常规检查和眼肌学的双眼视觉检查,根据检查的远近三棱镜度数设计手术量,进行斜视眼内直肌退后术、外直肌缩短术。计算手术量的三棱镜度数是在客观检查的度数基础上多加15~Δ。手术方式:内直肌后退,外直肌缩短,内直肌后退的量通常为4mm,外直肌缩短的量根据看远的斜视角确定。主要指标手术后斜视度数与复视情况。结果20例中有19例患者手术后观察3个月,且手术后看远与看近斜视度的三棱镜平均度数均小于+10~Δ,所有20例患者内直肌均后退4mm,外直肌缩短的毫米数根据斜视度的不同,一般在4～6mm范围内。6例和谐异常视网膜对应病例术后有矛盾性复视,其中3例在1个月内复视消失,2例在3个月左右消失,1例术后1周斜视复发,斜视三棱镜度数与术前接近,复视消失;其余14例异常视网膜对应的病例手术后无复视,眼位的内斜角度均小于+10~Δ,映光表现为正位。结论对于和谐及企图和谐异常视网膜对应的内斜患者手术量的计算应为客观检查的三棱镜度数多加15~Δ,内直肌后退量为4mm,术后矛盾性复视3个月内克服。
Objective To investigate the changes of binocular vision after operation, the amount of surgery, and the postoperative esophageal esotropia in patients with abnormal esophageal anomalies and the effect of the amount of surgery on the success rate of surgery. Design retrospective case series. The study included 20 patients with esotropia and abnormal anomalous retina corresponding to esotropia. Methods One hundred and twenty patients with esotropia and abnormal esophageal retinal esophagitis were treated in the Department of Ophthalmology, Peking University within one year. Routine ophthalmology routine ophthalmology and ophthalmology before the routine visual inspection, according to the degree of inspection near and far prism design of the amount of surgery, strabismus surgery rectus abdominis rectus, lateral rectus shortening surgery. Calculate the amount of surgery prism is the degree of objective examination based on the increase of 15 ~ Δ. Surgical approach: rectus medialis receding, lateral rectus shortened, the amount of rectus muscle retreat is usually 4mm, the amount of shortening of the lateral rectus muscle is determined according to the farsighted viewing angle. The main indicators of postoperative strabismus and diplopia cases. Results Nineteen of 20 patients were observed for 3 months after surgery. The mean degree of prism length and distance of near-strabismus after operation was less than + 10 ~ Δ, and all of the 20 patients had 4 mm of rectus receding, Shorten the number of millimeters according to different strabismus, usually in the range of 4 ~ 6mm. There were contradictory diplopia cases in 6 cases of abnormal retina. Among them, 3 cases disappeared in 1 month, 2 cases disappeared in 3 months, 1 case had strabismus recurrence 1 week after operation, Before the close, diplopia disappeared; the remaining 14 cases of abnormal retinal corresponding cases without diplopia, the angle of the eye were less than + 10 ~ Δ angle, the performance of the positive light mapping. Conclusions The calculation of the amount of surgery in patients with esotropia who are in harmony with or attempt to reconcile with anomalous retina should be done by adding 15 ~ Δ to the degree of objective prism examination and 4 mm in the rectus abdominis, and within 3 months after contradictory diplopia.