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目的探讨V征斜视的临床特点和手术方法及治疗效果。方法收集63例因V征斜视行下斜肌减弱术和常规水平直肌后退和(或)缩短术患者,回顾性总结和分析手术前、后的斜视度数,上、下注视眼位的斜视度数差,斜肌功能和双眼视功能状态。平均随访时间为8.2个月。结果62例(98.4%)患者合并双眼或单眼下斜肌功能亢进(+2或+3),行下斜肌减弱术和常规水平直肌后退和(或)缩短术;1例患者合并双眼下斜肌功能亢进(+1),仅行水平直肌后退缩短术。术前上、下注视眼位的斜视度数差为25.6△,随访末期为4.5△。48例外斜视V征患者术前水平斜视度数为(外斜)37.2△,随访末期为(内斜)3.4△,其中38例(79.2%)患者的斜视度数<±10△;15例内斜视V征患者术前水平斜视度数为50.6△,随访末期为(内斜)2.4△,其中11例(73.3%)患者的斜视度数<10△。术后21例(33.3%)患者恢复立体视功能。结论V征斜视患者多合并下斜肌功能亢进,减弱下斜肌功能可有效矫治V征斜视,常规斜视矫正方法可有效矫正水平斜视;术后患者立体视功能恢复情况良好。
Objective To investigate the clinical features and surgical methods of V syndrome and its therapeutic effect. Methods Sixty-three cases of patients with V retrograde oblique descending oblique and conventional horizontal rectus retraction and / or shortening were retrospectively reviewed and analyzed. The number of strabismus before and after surgery, the number of strabismus Poor, oblique muscle function and binocular vision status. The average follow-up time was 8.2 months. Results Sixty-two patients (98.4%) had binocular or monocular inferior oblique muscle hypertrophy (+2 or +3), underwent inferior oblique reduction and rectal retraction and / or shortening of conventional horizontal rectus muscle. One patient under binocular vision Oblique muscle function (+1), only the horizontal rectus retraction surgery. The difference in strabismus position between the upper and lower eyes before surgery was 25.6 △, and 4.5 △ at the end of follow-up. The preoperative horizontal strabismus score was (exotropia) 37.2 △ in the 48 cases with extrinsic strabismus V sign, and was 3.4 ° in the end of follow-up (esotropia). The strabismus number in 38 cases (79.2%) was ± 10 °. The preoperative level of strabismus was 50.6 △, the end of follow-up was (inward) 2.4 △, of which 11 (73.3%) patients with strabismus <10 △. Twenty-one patients (33.3%) recovered stereopsis. Conclusions In patients with V-strabismus, multiple combined inferior oblique muscle dysfunction and weakened inferior oblique muscle function can effectively correct V-strabismus. Strabismus can be effectively corrected by conventional methods of strabismus. The recovery of stereopsis is good after surgery.