压贴三棱镜治疗儿童间歇性外斜视手术过矫导致继发性内斜视的临床效果观察
Observation on the clinical efficacy of press-on prism in the treatment of secondary esotropia caused by overcorrection of intermittent exotropia surgery in children
王飞 1楚瑞雪 1黄方 1王惠1
作者信息
- 1. 郑州大学附属儿童医院眼科 河南省儿童医院 郑州儿童医院,郑州 450000
- 折叠
摘要
目的 观察压贴三棱镜治疗儿童间歇性外斜视手术过矫导致继发性内斜视患者的眼位及立体视功能恢复效果.方法 前瞻性随机对照研究.纳入郑州大学附属儿童医院 2019 年 1 月至2024 年 1 月 80 名间歇性外斜视手术过矫导致继发性内斜视患儿,按随机数字表法分为对照组(仅戴镜,40 例)和研究组(戴镜+压贴三棱镜,40 例),对比两组患者眼位、立体视及双眼视功能恢复效果.结果 研究组眼位正位率为 90.00%(36/40),高于对照组的 65.00%(26/40);欠矫率为 7.50%(3/40),低于对照组的 35.00%(14/40)(χ2=7.17、9.04,P=0.007、0.003).术后 6 个月,两组立体视率均提升(χ2研究组=48.08,χ2对照组=17.80;均P<0.001),黄斑中心凹立体视率均上升(χ2研究组=16.81,χ2对照组=5.00;P研究组<0.001,P对照组=0.025);研究组黄斑及周围立体视率显著提升(χ2=12.47、6.28;P<0.001,0.012),且研究组无立体视、黄斑中心凹立体视、黄斑立体视级周围立体视率优于对照组(χ2=9.03、4.94、4.59、4.50,P=0.003、0.026、0.032、0.034).术后 6 个月,研究组存在立体视者为 16例(40.00%)、存在融合功能者 34 例(85.00%)、存在同时视功能者 21 例(52.50%),明显高于对照组的7 例(17.50%)、19 例(47.50%)、10 例(25.00%),差异均有统计学意义(χ2=4.94、12.58、6.37,P=0.026、<0.001、0.012).结论 应用压贴三棱镜治疗间歇性外斜视术后过矫导致继发性内斜视患儿,可提高眼位的正位率,促进恢复立体视和双眼视功能,减少无立体视觉的发生率.
Abstract
Objective To observe the efficacy of the recovery of eye position and stereoscopic function in children using a press-on prism for the treatment of secondary esotropia caused by overcorrection of intermittent exotropia surgery in children.Methods A prospective randomized controlled study was conducted on 80 children with secondary esotropia caused by intermittent exotropia surgical overcorrection at Zhengzhou University Children's Hospital from Jan.2019 to Jan.2024.The patients were divided into a control group(wearing glasses only,40 cases)and a study group(wearing glasses and press-on prism,40 cases)by using a random number table method.The recovery results of eye position,stereoscopic vision,and binocular vision function were compared between the two groups.Results The positive rate of eye position of the study group was 90.00%(36/40),which was higher than the 65.00%(26/40)of the control group.The undercorrection rate was 7.50%(3/40),which was lower than the 35.00%(14/40)of the control group(χ2=7.17,9.04;P=0.007,0.003).At 6 months after surgery,both groups showed improvements in stereoscopic vision rate(χ2study group=48.08,χ2control group=17.80;all P<0.001),and the stereoscopic vision rate of the macular fovea increased(χ2study group=16.81,χ2control group=5.00;Pstudy group<0.001,Pcontrol group=0.025);The study group had a significant improvement in macular and peripheral stereoscopic vision rate(χ2=12.47,6.28;P<0.001,0.012),and had no stereoscopic vision,no macular foveal stereoscopic vision,and better peripheral stereoscopic vision rate compared with the control group(χ2=9.03,4.94,4.59,4.50;P=0.003,0.026,0.032,0.034).At 6 months after surgery,the study group had 16 cases of stereoscopic vision(40.00%),34 cases of fusion function(85.00%),and 21 cases of simultaneous visual function(52.50%),which were significantly higher than the 7 cases(17.50%),19 cases(47.50%),and 10 cases(25.00%)which the control group had,and the differences were statistically significant(χ2=4.94,12.58,6.37;P=0.026,<0.001,0.012).Conclusion Application of press-on prism in the treatment of secondary esotropia caused by overcorrection of intermittent exotropia surgery in children can improve the positive rate of eye position and promote the recovery of stereoscopic and binocular vision functions,and reduces the rate of non-stereoscopic vision.
关键词
外斜视,间歇性/内斜视,继发性/三棱镜,压贴/功能,立体视Key words
Exotropia,intermittent/Esotropia,secondary/Prism triangular,pressing and pasting/Stereoscopic function引用本文复制引用
出版年
2024
NETL
NSTL
万方数据