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目的探讨先天性内斜视术后双眼单视功能的发育状况。方法把45例先天性内斜视患儿分≤2岁组,≤5岁两组,≤2岁组12人,≤5岁组33人,术前用同视机和颜少明《立体视觉检查图》检测立体视功能(2岁前组不理解除外)。术后行双眼单视功能训练9月至1年。结果术前≤2岁组未查,≤5岁组术前全部无双眼单视。术后通过训练,≤2岁组中有2例有中心凹立体视觉,4例周边立体视觉,2例Ⅱ级视功能,4例Ⅰ级视功能。≤5岁组无一例有中心凹立体视觉,5例有周边立体视觉,6例周边融合,3例中心融合,11例仅有Ⅰ级视功能,8例无同时知觉。两组相比较有显著性差异(P<0.05)。结论手术年龄对患儿术后的双眼视觉发育至关重要,先天性内斜视2岁前手术可望获得亚正常双眼视觉,2岁后手术者获得较好的双眼视觉可能性极小。
Objective To investigate the development of binocular monovision after congenital esotropia. Methods 45 cases of congenital esotropia in children ≤ 2 years old group, ≤ 5 years old two groups, ≤ 2 years old group of 12, ≤ 5 years old group of 33 patients with preoperative esopostomy and Yan Shaoming “stereoscopic examination” test Stereoscopic function (2-year-old group did not understand except). Postoperative binocular vision training nine months to one year. Results preoperative ≤ 2 years old group did not check, ≤ 5 years old group without preoperative binocular vision. After training, 2 patients in ≤2 years group had stererural vision, 4 cases of peripheral stereopsis, 2 cases of grade Ⅱ visual function and 4 cases of grade Ⅰ visual function. None of the 5-year-olds had stereoscopic vision, 5 had peripheral stereopsis, 6 had peripheral fusion, 3 had central fusion, 11 had only Grade I visual function, and 8 had no simultaneous perception. There was significant difference between the two groups (P <0.05). Conclusions The age of operation is crucial to the development of binocular vision in children. Subtanoary binocular vision is expected to be achieved before surgery in children with congenital esotropia. The probability of obtaining binocular vision after surgery is very low after 2 years of age.