【摘要】 目的 了解成人共同性斜视矫正术后,眼位及视功能恢复情况。方法 将我院2003～2004年手术矫正大龄共同性斜视114例患者进行分析，其中男58例，女56例。年龄17～54岁，平均24.5岁。共同性内斜视28例，共同性外斜视86例。屈光不正85例，弱视52例。斜视角<50△者27例，≥50△87例。术后早期进行视功能训练7～10次。术后观察1～16个月。结果 眼位矫正满意，正位98例，占85.94%，欠矫15例，外观满意未行二次手术，过矫者1例，配压贴三棱镜矫正。术后经过训练恢复视功能者14例，占12.28%。结论 成人斜视手术主要是美容矫正，视功能很难恢复。故弱视、斜视应早期治疗。有手术指征者应及时手术。
【关键词】 成人共同性斜视；眼位；视功能
Surgery of adult concomitant strabismusCHEN Dan,
GONG Shu-xian.Aier Eye Hospital of Wuhan,Wuhan 430063,China
【Abstract】 Objective To acquaint the adult with eye position and the resumptive instance of visual function after the surgery of the concomitant strabismus.Methods There were 114 patients who had accepted the surgery of the concomitant strabismus from 2003 to 2004.58 cases were man while 56 cases were women.The patients age were from 17 to 54 years old,and average 24.5 years old.28 cases were concomitant esotropia while 86 cases were concomitant exotropia.85 cases were ametropia and 52 cases were amblyopia.27 cases angle of strabismus was less than 50°,while 87 cases angle was more than 50°.The training of visual function were 7～10 times after surgery early.All patients had been observed from 1 to 16 months.Results Eye position was satisfactory after surgery.98 cases were orthophoria and occupied 85.94%.15 cases were lack of correction.But the patients satisfied themselves with the Press-Optics.14 cases visual function resumed after the training and occupied 12.28%.Conclusion The main aim of the adults surgery of strabismus is hairdressing,but the resume of visual function is hardly possible.So the patient who has amblyopia or strabismus need the operation earlier and the patient who has operating indication must accept the operation in time.
【Key words】 adult concomitant strabismus;eye position;visual function
成人斜视多因某种原因失去早期手术机会，随着生活水平的提高，成年人要求美容手术者逐渐增多，现将近2年在我院进行斜视矫正手术的大龄患者114例，分析报告如下。
1 资料与方法
1.1 一般资料 我院2003～2004年手术矫正大龄共同性斜视114例，男58例，女56例。年龄17～54岁，平均24.5岁。共同性内斜视28例，共同性外斜视86例。术后观察1～16个月。
1.2 检查方法 常规检查视力、矫正视力、眼位、眼球运动、眼底及视功能。
采用标准对数视力表查视力，低于0.8者使用睫状肌麻痹剂扩瞳验光，检出屈光不正85例，弱视52例，其中远视性屈光不正16例，近视性屈光不正57例，混合散光12例。轻度弱视17例，中度弱视8例，重度弱视27例。
用角膜映光法、三棱镜加交替遮盖法分别检查33cm和5m斜视角。内斜组：斜角<50△者10例，≥50△者18例；外斜组：斜角<50△者17例，≥50△者69例。用同视机检查双眼单视功能，术前均无双眼视功能。
1.3 手术方法 根据斜视角大小设计手术，内斜组首选单眼式双眼内直肌减弱术，>50△者加主斜眼外直肌缩短术。外斜组首选单眼式双外直肌减弱术，>50△者加主斜眼内直肌缩短术。手术均在局麻下进行，术中观察眼位正位或少欠矫，无复视为宜。术后第2天用同视机进行视功能训练7～10天。
2 结果
眼位矫正结果评价参照中华眼科学会全国弱视斜视防治学组1996年制定的疗效评定标准进行评定［1］。眼位正位者98例，欠矫15例，外观满意未进行二次手术。过矫1例，配压贴三棱镜矫正。术后经过训练，恢复双眼三级功能者14例，占12.28%。见表1。表1 术后眼位及双眼视功能
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