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目的探讨V型斜视的手术方法及术后双眼单视功能的状况。方法31例V型斜视伴有斜肌功能亢进的22例行斜肌断腱+水平肌后徙、缩短+水平肌止点垂直移位术;不伴斜肌功能亢进9例行水平肌后徙、缩短+水平肌止点垂直移位术;术后对无双眼单视功能的病例用同视机进行双眼单视功能训练。结果31例中V征矫正满意25例(80.6%),欠矫6例(19.4%),欠矫者术前V征斜视度差值均>35△。术前无双眼单视功能的28例术后经同视机训练21例年龄在17岁以下的病例获得双眼单视功能,Ⅰ级2例,Ⅱ级4例,Ⅲ例15例。结论V征产生原因是多因素的,可根据有无斜肌功能亢进选择术式,对有斜肌功能异常的行斜肌断腱+水平肌后徙、缩短+水平肌止点垂直移位术疗效满意。术后进行双眼单视功能训练,超过视觉发育敏感期的病例仍有部分能获得良好的双眼单视功能。
Objective To investigate the surgical methods of V-type strabismus and the status of binocular monovision after operation. Methods Twenty-one patients with V-type strabismus with oblique muscle function were retrospectively analyzed. Twenty-two cases of oblique muscle tendon + , Shortening the horizontal muscle + point of vertical displacement; postoperative unilateral binocular vision cases with binocular binocular vision function training. Results Among 31 cases, the correction of V-curve was satisfactory in 25 cases (80.6%) and in 6 cases (19.4%) due to undercorrection, and the difference in V-strabism before surgery was> 35 △. 28 cases of preoperative non-binocular monophasic function were treated by the same time, 21 cases of patients under the age of 17 under the eyes of binocular visual function, 2 cases of grade Ⅰ, Ⅱ in 4 cases, Ⅲ in 15 cases. Conclusions The cause of V syndrome is multifactorial. According to the choice of surgical treatment of oblique muscular function, the vertical displacement of horizontal muscle myocutaneous point should be shortened Satisfactory results. Postoperative binocular single function training, more than the visual development of sensitive cases, some patients still get good binocular vision function.