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題名 | 斜視之手術治療(15)--斜視手術後眼位偏移趨勢的探討=Postoperative Eye Drift in Horizontal Strabismus |
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作者 | 張詠青; 林惠朗; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 36:2 1997.06[民86.06] |
頁次 | 頁106-119 |
分類號 | 416.7551 |
關鍵詞 | 斜視; 手術治療; Eye position; Eso-drift; Exo-drift; Postoperative drift; |
語文 | 中文(Chinese) |
中文摘要 | 本篇一共收集366位只接受一次斜視手術矯正的共�T性水平斜視的病例(其中內斜 視有230人;外斜視有136人)。追蹤時間3~15年,平均6.2年,來觀察術後眼位移動的趨勢 。在內斜視的病人中,術後三個月內眼位維持不變的有75.2%,內移者有13%,外移者有 11.7%。在平均6.3年的最後觀察時,眼位維持不變的只剩35.2%,呈內移者有21.7%,呈外 移者有43%。有立體感的病人眼位較穩定,有統計學上的意義;而做兩側內直肌移後手術者 ,比只做單眼移後/切除手術者更有意義地會呈外轉趨勢(p<0.05)在外斜視的病人中,術後 三個月內眼位維持不變的有 76.5%,內移者有 7.4%,外移者有 16.2%。在平均 6.1 年的最 後觀察時,眼位維持不變的只剩 33.1%,呈內移者有 11.0%,呈外移者有 55.9%。外斜視之 外移趨勢顯然比內斜視更明顯 (P<0.05)。但在外斜視這種趨勢不受特定因素的影響。 |
英文摘要 | The unpredictable postoperative drift of ocular alignment is one of the major obstacles to the ideal goal of strabismus surgery. We find that a significant portion of patients with comitant strabismus (esoropia & exotropia) will reveal postoperative drift if the interval of postoperative observation is long enough, at least several years. In our study, the longterm drift rate of esotropia (230 cases, average follow-up period:6.3 years) is 64.8%;and that of exotyropia(136 cases, average follow-up period:6.1 years)is 66.9%. Among the groups with postoperative drift, we find that patients with exo-drift (drift of exotropic direction) outnumber those with eso-drift (esotropic direction). This is especially prominent in the exotropes (exo-drift:55.9%;eso-drift;11.0%) than in the esotropes (exo-drift:43.0%; eso-drift:21.7%). Nevertheless, there is a small but innegligible proportion manifests postoperative eso-drift. Some factors may influence the postoperative drift. We make comparison of the drift patterns between different types of strabismus, different methods of operation, presence of motor fusion or not, presence of sensory fusion(stereoacuity) or not, different age groups on operation, adn different refractive states. The t-test is used to testify if any correlation exists between these factors and the postoperative drift. We find that patients of exotropia exhibit an accordantly exo-drift pattern, which is not influenced by any of the factors. Yet, esotropes show better postoperative stability of ocular alignment (i.e. less drift) if they are verified to have some degree of sensory fusional ability (stereoacuity). In addition, esotropes that receive bilateral surgery (bilateral medial rectus muscle recession) have a stronger disposition of exo-drift than those receiving monocular surgery (recession & resection). |
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