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目的: 探讨 A型外斜视的病因、临床特征、手术治疗方法及疗效。方法: 分析自 1995- 01/2003- 12 收治的 1 825 例斜视中62 例 A 型外斜视病例的病历资料及治疗效果。所有患者依据是否伴有上斜肌功能过强、原位水平斜视及双眼视觉功能情况行上斜肌部分肌腱切除术或断腱术和 / 或水平直肌手术, 术后随访时间 6￣18( 平均 9) mo。结果: A型外斜视占同期斜视患者 3.4%。在同期所有的A- V征中, A- 外斜占 21.2%; 术后眼位恢复正位 52 例( 83.9%) , A征消失 56 例( 90.4%) , 术后 54 例获得立体视功能( 包括术前 3 例存在立体视功能患者) 。结论: A型外斜视是一种较常见的斜视类型, 发病原因以斜肌功能异常为主, 常合并水平斜视, 应依据是否伴有斜肌功能异常及双眼视情况, 选择不同的手术方式, 可获得满意的术后效果。
Objective: To investigate the etiology, clinical characteristics, surgical treatment and efficacy of type A exotropia. Methods: The data of 62 cases of type A exotropia from 1 825 cases of strabismus admitted from 1995 to 01 / 2003-12 were analyzed retrospectively. All patients according to whether the upper oblique function is too strong, in situ horizontal strabismus and binocular visual function on the oblique part of tendon resection or tendon surgery and / or horizontal rectus muscle surgery, postoperative follow-up time 6-18 ( Average 9) mo. Results: Type A exotropia accounted for 3.4% of patients with strabismus in the same period. Among all the A-V signs in the same period, A-diagonosis accounted for 21.2%; in 52 cases (83.9%), the A-sign disappeared in 56 cases (90.4%) after operation and 54 cases got stereopsis (Including 3 patients with stereopsis before surgery). Conclusion: A type of exotropia is a more common type of strabismus, the main cause of oblique dysplasia, often combined with horizontal strabismus, should be based on whether there is associated with oblique muscle dysfunction and binocular vision, choose a different surgical approach, Can be satisfied with the postoperative results.