目的:探讨成功矫正眼位后间歇性外斜视患儿双眼立体视恢复情况及其影响因素。
方法:前瞻性临床研究。共178名患者,年龄9~14(10.8±1.7)岁,收集2023年10月至2023年9月在首都医科大学附属北京同仁医院进行间歇性外斜视手术后成功矫正的患者,随访时间为6个月或更长.配对t检验,采用Pearson相关分析和多变量线性回归分析来探讨可能预测术后6个月立体视的术前临床特征。
结果:手术后六个月,患者的偏离角度符合原位标准,与手术前相比差异有统计学意义(远距:-2.7△±3.2△vs.-30.5△±8.4△,t=-25.3,P<0.001。近:-3.7△±4.1△vs.-33.7△±8.0△,t=-26.1,P<0.001)。远处立体视觉(3.0±0.6vs.3.9±0.4,t=4.9,P<0.05)和近立体视(2.3±0.5vs.2.6±0.4,t=3.8,P<0.05)均较术前明显改善。17%和22%的患者重建正常远距立体视和正常近立体视,分别。术前远处立体视(r=-0.26,P=0.004)和近立体视(r=-0.23,P=0.011)与收敛储备呈显著负相关。多变量分析表明,患者年龄(β=0.003,p=0.037),屈光参差(β=0.015,p=0.043),术前远处立体视(β=0.456,p<0.001)与术后远处立体视显著相关。患者年龄(β=0.005,p=0.044),屈光参差(β=0.127,p=0.034),偏差角(β=-0.230,p=0.020),术前近立体视(β=0.136,p<0.001)与术后近立体视显著相关。
结论:IXT患者可以在手术后获得眼位固定,约20%的患者受益于立体视觉改善.病人的年龄,双眼屈光参差,偏角和术前立体视是影响术后立体视的独立因素。
OBJECTIVE: To investigate the recovery of binocular stereopsis recovery and its influencing factors in children with intermittent
exotropia after successful correction of eye position.
METHODS: Prospective clinical study. A total of 178 patients, aged 9 ∼ 14 (10.8 ± 1.7) years, who were successfully corrected after intermittent
exotropia surgery at the Beijing Tongren Hospital Affiliated to Capital Medical University from October 2023 to September 2023 were collected, the follow-up duration was six-month or longer. Paired t test, Pearson correlation analysis and multivariable linear regression analysis were used to probe preoperative clinical features that may predict the stereopsis six months after surgery.
RESULTS: Six months after surgery, the angle of deviation of the patients met the orthotopic standard, and there was significant difference compared with that before surgery (distant: -2.7△±3.2△ vs. -30.5△±8.4△, t=-25.3, P < 0.001. Near:-3.7△±4.1△ vs. -33.7△±8.0△, t=-26.1, P < 0.001). Distant stereopsis (3.0 ± 0.6 vs. 3.9 ± 0.4, t = 4.9, P < 0.05) and near stereopsis (2.3 ± 0.5 vs. 2.6 ± 0.4, t = 3.8, P < 0.05) were both significantly improved compared with that of before surgery. 17% and 22% patients rebuilt normal distant stereopsis and normal near stereopsis, respectively. Preoperative distant stereopsis (r=-0.26, P = 0.004) and near stereopsis (r=-0.23, P = 0.011) was significantly negatively correlated with convergence reserve. Multivariable analysis showed that patients\' age (β = 0.003, p = 0.037), anisometropia (β = 0.015, p = 0.043), and preoperative distant stereopsis (β = 0.456, p < 0.001) were significantly associated with postoperative distant stereopsis. Patients\' age (β = 0.005, p = 0.044), anisometropia (β = 0.127, p = 0.034), angle of deviation (β=-0.230, p = 0.020), and preoperative near stereopsis (β = 0.136, p < 0.001) were significantly associated with postoperative near stereopsis.
CONCLUSIONS: IXT patients could get eye position fixed after surgery, about 20% patients benefited from stereopsis improvement. Patient\'s age, binocular anisometropia, angle of deviation and preoperative stereopsis were independent factors influencing postoperative stereopsis.