摘要
Abstract
Objective To observe the effect of monocular medial rectus shortening combined lateral rectus recession in the treatment of children with convergence insufficiency type of intermittent exotropia(IXT).Methods The data of children with convergence insufficiency type of IXT admitted to the hospital from June 2022 to June 2023 were retrospectively analyzed.According to different surgical methods,they were divided into binocular group(binocular medial rectus shortening)and monocular combined group(monocular medial rectus shortening combined with lateral rectus recession).The propensity score matching method(caliper=0.01,with a ratio of 1:1)was used to match the binocular group and monocular combined group.Finally,42 children with balanced and comparable baseline data were obtained in each group.The surgical effect,complications,and strabismus degree(near vision,far vision,near-to-far vision strabismus difference),visual function,near stereopsis and appearance satisfaction before surgery and at 6 months after surgery were compared.Results At 1 week after surgery,the correction rate in monocular combined group with 90.48%was significantly higher than 71.43%in binocular group(P＜0.05),while the overcorrection rate with 9.52%was lower than 28.57%in binocular group(P＜0.05).At 6 months after surgery,the overcorrection rate and undercorrection rate in binocular group were significantly different from those at 1 week after surgery(P＜0.05).There was no significant difference in the correction rate between the two groups at 6 months after surgery(P＞0.05).The incidence rates of complications showed no obvious differences between the two groups(P＞0.05).At 6 months after surgery,the near vision,far vision and near-to-far vision strabismus difference were decreased in both groups(P＜0.05),and the above indicators in monocular combined group were lower than those in binocular group at 6 months after surgery(P＜0.05).The visual function of grade I,grade Ⅱ and grade Ⅲ in the two groups were significantly improved at 6 months after surgery(P＜0.05).There was no significant difference in visual function between the two groups at 6 months after surgery(P＞0.05).At 6 months after surgery,the normal rate of near stereopsis function in the two groups was significantly enhanced,and there was no significant difference between groups(P＞0.05).The satisfaction rate was 92.86%in monocular combined group,which was higher than that 76.19%in binocular group(P＜0.05).Conclusion Compared with binocular medial rectus shortening,monocular medial rectus shortening combined with lateral rectus recession can reduce the near and far strabismus of patients with convergence insufficiency type of IXT,improve the short-term correction rate after surgery,and enhance the aesthetic effect,and has clinical application value.关键词
间歇性外斜视(IXT)/单眼内直肌缩短/外直肌后徙术/斜视度/视功能Key words
intermitent exotropia(IXT)/monocular medial rectus shortening/lateral rectus recession/strabismus/visual function分类
医药卫生
