梁光丽 白莹 文勇 曾春梅 邓斌

[摘要]目的：探討直肌边缘切开术与配戴三棱镜对共同性内斜视患者眼位矫正效果及视力恢复的影响。方法：2018年1月-2020年1月在笔者医院进行治疗的共同性内斜视患者中选出80例，按照治疗方法的不同分为对照组和观察组，每组40例，对照组采用配戴三棱镜治疗，观察组采用直肌边缘切开术治疗，比较两组患者治疗前后的正位率、残存斜视度、融合功能、融合范围、近立体视功能变化。结果：观察组患者治疗1周、术后1个月、3个月的正位率显著高于对照组，差异有统计学意义（P<0.05）;治疗6个月后观察组的正位率稍高于对照组，但差异无统计学意义（P>0.05）。两组治疗前的残存斜视度比较差异无统计学意义（P>0.05）;观察组治疗1周、1个月、3个月、6个月后的残存斜视度显著低于对照组，差异有统计学意义（P<0.05）。两组治疗前、治疗1周后的融合功能正常率比较差异无统计学意义（P>0.05）;观察组治疗1个月、3个月、6个月后的融合功能正常率高于对照组，差异有统计学意义（P<0.05）。两组治疗前的融合范围比较差异无统计学意义（P>0.05）;治疗1周、1个月、3个月、6个月的融合范围大于对照组，差异有统计学意义（P<0.05）。观察组治疗后1周、1个月、3个月、6个月的精细立体视功能恢复较对照组好，但差异无统计学意义（P>0.05）。结论：与配戴三棱镜相比，直肌边缘切开术能够有效矫正共同性内斜视，有助于双眼融合功能与立体视功能的恢复。

[关键词]共同性内斜视;直肌边缘切开术;三棱镜;眼位矫正;立体视功能恢复

[中图分类号]R777.4+1    [文献标志码]A    [文章编号]1008-6455（2021）07-0040-04

Comparison of the Efficacy of Rectus Marginal Incision and Prism in the Treatment of Concomitant Esotropia

LIANG Guang-li，BAI Ying，WEN Yong，ZENG Chun-mei，DENG bin

（Department of Ophthalmology，the Sixth People's Hospital of Chengdu，Chengdu 610051，Sichuan，China）

Abstract： Objective  To investigate the impact of rectus marginal incision and prism on eye position correction and vision recovery in patients with concomitant esotropia. Methods  80 patients with concomitant esotropia treated in the hospital were selected as the research subjects between January 2018 and January 2020. According to the treatment method， the patients were divided into the control group and the observation group， 40 cases in each group. The control group wore the prism for treatment， while the observation group was treated with rectus marginal incision. Changes in orthotopic rate， residual strabismus degree， fusion function， fusion range and near stereopsis before and after treatment were compared between the two groups. Results  The orthostatic rate in the observation group was significantly higher than that in the control group after one week， one month and 3 months of treatment， the difference were statistically significant （P<0.05）. After 6 months of treatment， the positive rate of the observation group was slightly higher than that of the control group， but the difference was not statistically significant （P>0.05）. There was no significant difference in residual strabismus degree between the two groups before treatment （P>0.05）. The residual strabismus degree of the observation group was significantly lower than that of the control group after one week， one month， 3 months and 6 months of treatment （P<0.05）. There was no significant difference in the normal rate of fusion function between the two groups before treatment and after one week of treatment （P>0.05）. The normal rates of fusion function in the observation group after one month， 3 months and 6 months of treatment were higher than those in the control group （P<0.05）. There was no significant difference in fusion range between the two groups before treatment （P>0.05）. The observation group had larger fusion range than the control group after one week， one month， 3 months and 6 months of treatment （P<0.05）. After one week， one month， 3 months and 6 months of treatment， the recovery of fine stereopsis function in the observation group was better than that in the control group， but the difference was not statistically significant （P>0.05）. Conclusion  Compared with wearing the prism， rectus marginal incision can effectively correct concomitant esotropia and help restore binocular fusion and stereopsis.

Key words： concomitant esotropia; rectus marginal incision; prism; eye position correction; stereoscopic function recovery

共同性内斜视是指双眼视轴分离，眼外肌及其支配神经无器质性病变，在各个方向，不论何眼为注视眼，其偏斜度均相等[1-2]。共同性内斜视的发病原因非常复杂，临床主要表现为间歇式内斜视、暂时性复视、单眼注视、弱视[3-4]。共同性内斜视一般发生在出生后早期，视功能发育尚不成熟，不仅会影响美观，还会导致视觉功能发育不良，影响立体视觉的建立，因此早发现早治疗十分必要[5]。配戴……