[摘要]目的：探究双眼外直肌倾斜后徙术（Slanted lateral rectus recession，S-LR）矫治集合不足型间歇性外斜视（Convergence insufficiency type of IXT，CI-IXT）的美学效果及对视觉功能的影响。方法：回顾性分析2021年8月-2023年8月笔者医院收治的80例CI-IXT患儿的临床资料，按手术治疗方式的不同分成双眼外直肌后徙术组（LR组，42例）和S-LR组（38例）。随访3个月比较两组疗效、视斜视度[视远/近斜视度、远/近斜视度差（Near-distant disparity，NDD）]、视觉功能（立体视、融合视、同时视功能）、间歇性外斜视生活质量量表（The Chinese version of intermittent exotropia questionnaires，CIXTQ）评分、复发率和美学效果的差异。结果：术后3个月，S-LR组手术矫正的优良率高于LR组，复发率低于LR组（P＜0.05）；两组视近斜视度、远斜视度、NDD均低于同组术前，且S-LR组低于LR组（P＜0.05）；两组立体视、融合视、同时视功能恢复占比均高于同组术前（P＜0.05），而S-LR组与LR组间视功能恢复情况无明显差异（P＞0.05）；两组CIXTQ量表中儿童/家长代理量表、家长量表评分均高于同组术前，且S-LR组高于LR组（P＜0.05）；S-LR组斜视角度、眼球位置、眼球对称、眼部外观、面部整体外观等美学效果评分均高于LR组（P＜0.05）。结论：应用S-LR治疗CI-IXT能有效提高手术矫正优良率，改善患儿的斜视度，促进视觉功能恢复，提高生活质量和美学效果，减少病情复发。

[关键词]外直肌倾斜后徙术（S-LR）；集合不足型；间歇性外斜视；美学效果；视觉功能

[中图分类号]R779.6" " [文献标志码]A" " [文章编号]1008-6455（2025）08-0016-05

Aesthetic Effect of Slanted Lateral Rectus Recession in the Treatment of Convergence Insufficiency Type of Intermittent Exotropia and Its Influences on Visual Function

LI Yunfeng1， LIU Yuchao2， YU Jiaxue1

（ 1.Department of Comprehensive Ophthalmology， Suihua Aier Ophthalmology Hospital， Suihua 152000， Heilongjiang， China; 2.Department of Strabismus and Pediatric Ophthalmology， Harbin Aier Ophthalmology Hospital， Harbin 150000，

Heilongjiang， China ）

Abstract： Objective" To explore the aesthetic effect of slanted lateral rectus recession （S-LR） in the treatment of convergence insufficiency type of intermittent exotropia （CI-IXT） and its influences on visual function. Methods" A retrospective analysis was performed on the clinical data of 80 children with CI-IXT in the hospital between August 2021 and August 2023. According to different treatment methods， they were divided into lateral rectus recession （LR） group （42 cases） and S-LR group （38 cases） . After 3 months of follow-up， curative effect， strabismus degree [distance/near strabismus， near-distant disparity （NDD）]， visual function （stereovision， fusion vision， simultaneous vision function）， scores of the Chinese version of intermittent exotropia questionnaires （CIXTQ）， recurrence rate and aesthetic effect in the two groups were compared. Results" At 3 months after surgery， good rate of surgical correction in S-LR group was higher than that in LR group， and recurrence rate was lower than that in LR group （P＜0.05）. After surgery， near strabismus， distance strabismus and NDD were decreased in both groups， which were lower in S-LR group than LR group （P＜0.05）. After surgery， proportions of stereovision， fusion vision and simultaneous visual function recovery were increased in both groups （P＜0.05）， but there was no significant difference in visual function recovery between the two group （Pgt;0.05）. After surgery， scores of CIXTQ （child/parent agency scale， parent scale） were increased in both groups， which were higher in S-LR group than LR group （P＜0.05）. The scores of aesthetic effect （strabismus angle， eyeball position， eyeball symmetry， ocular appearance， overall facial appearance） in S-LR group were higher than those in LR group （P＜0.05）. Conclusion" S-LR can effectively improve good rate of surgical correction and strabismus degree， promote recovery of visual function， improve quality of life and aesthetic effect， and reduce disease recurrence in CI-IXT children.

Key words： slanted lateral rectus recession; convergence insufficiency type; intermittent exotropia; aesthetic effect; visual function

间歇性外斜视（IXT）是指因遗传、视觉发育不良等原因导致外展与集合功能失衡，无法对抗过强外展力致眼位外斜的眼科疾病[1]。多于患儿劳累、视远物、注意力不集中时出现，随着外斜次数、频率致角度增加，不仅会出现复视、视物模糊等视功能损害[2]，还会影响外貌，使患儿产生自卑、社交退缩等心理，降低了生存质量[3]。……