王玉瑾 王吉翔 赵瑜 李晓林

[摘要] 目的 探讨健眼手术治疗知觉性外斜视的矫正效果。方法 随机选取60例患者分两组行健眼（外直肌后徙术和/或内直肌缩短术）及斜视眼手术（外直肌超常量后徙联合内直肌缩短术）矫正斜视。比较术前术后眼位矫正效果。健眼手术组平均手术量11.39 mm，手术均为1 次完成。斜位眼手术组平均手术量19.17 mm。 结果 该组采用两种手术方法分别对60例知觉性外斜视患者进行治疗， 健眼手术组根据三井幸彦对主眼的手术量按（斜角÷3） mm 计算， 斜角>15°分二份，健眼手术矫正知觉性外斜视，手术量明显低于仅斜眼手术组，疗效优于斜视眼手术组。结论 健眼手术是矫正知觉性外斜视的有效手术方式。

[关键词] 知觉性外斜视；健眼；非主导眼；眼外肌

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）03（c）-0076-02

Clinical Analysis of Healthy Eye Operation in Treatment of 60 Cases with Sensory Exotropia

WANG Yu-jin， WANG Ji-xiang， ZAHO Yu， LI Xiao-lin

Department of Ophthalmology， Lanzhou First People's Hospital of Gansu Province， Lanzhou，Gansu Province，730050 China

[Abstract] Objective To discuss the corrective effect of the healthy eye operation in treatment of sensory exotropia. Methods 60 cases of patients were divided into two groups and were given healthy eye operation （lateral rectus muscle recession and/or medial rectus shortening） and squinting eye operation （supernormal lateral rectus muscle recession combined with medial rectus shortening to correct the squint， the corrective effects of the eye position before and after operation were compared， the mean operative amount in the healthy eye operation group was 11.39 mm， the operation was finished once， the mean operative amount in the squinting eye operation group was 19.17 mm. Results In this group， the two operative methods were adopted to respectively treat the 60 cases of patients with sensory exotropia， the operative amount of leading eye by Mitsui Yukihiko was divided into two according to the formula of （oblique angle÷3） mm and oblique angle >15°by the healthy eye group， the sensory exotropia was corrected by the healthy eye operation， the operative amount in the healthy eye operation group was obviously lower than that in the squinting eye operation group， the curative effect in the healthy eye operation group was better than that in the squinting eye operation group. Conclusion The healthy eye operation is an effective operative method of correcting sensory exotropia.

[Key words] Sensory exotropia； Healthy eye； Non-dominant eyes； Extraocular muscles

由于婴幼儿早期单眼视力发育障碍，或因发育过程中、成人后外伤眼病导致视力严重受损或失明，都可能发生知觉性外斜视，前者是因辐辏反射尚未发育而引起的，后者则是因辐辏功能减弱而发生，均可手术纠正。现结合该院在2013年1月—2014年5月之间的60例知觉性外斜视患者的实际情况，并且对该类型的手术进行深入的分析，研究发现在健眼进行手术治疗效果明显，并且手术次数和手术量相比斜眼手术来说都少[1]，现报道如下。

1 资料与方法

1.1 一般资料

随机选取该科知觉性外斜视患者的60个案例进行深入分析，随机编排为两组，其中的健眼手术有30例，年龄分布在9～42岁。差异……