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目的探讨V型斜视的手术治疗效果及术后双眼单视功能状况。方法对48例V型斜视按下斜肌功能状况分为四组:Ⅰ组V型外斜视伴有下斜视肌功能亢进17例;Ⅱ组V型外斜视无明显下斜肌功能亢进10例; Ⅲ组V型内斜视伴下斜肌功能亢进14例;Ⅳ组V型内斜视无明显下斜肌亢进7例;对Ⅰ组和Ⅲ组行内外斜视矫正同时行单(双)侧下斜肌后徙术,对Ⅱ和Ⅳ组行内外斜视矫正同时行水平直肌附着点垂直移位术。结果Ⅰ组患者术后原在位眼位-8△-+3△向上与向下注视时斜视角差≤4△。Ⅱ组原在位眼位-10△-+5△向上与向下注视时斜视角差≤8△。Ⅲ组原在位眼位-4△-+6△向上与向下注视时斜视角≤4△。Ⅳ组原在位眼位-5△-+10△,向上与向下斜视角差为7△。结论采用两种术式矫正V型斜视疗效确切,下斜肌后徙较水平直肌附着点垂直移位效果明显,并且有希望建立双眼单视功能。
Objective To investigate the surgical treatment of V-type strabismus and the postoperative binocular vision status. Methods Forty-eight patients with V-type strabismus were retrospectively divided into four groups: Group I with V-type exotropia with 17 cases of hypophyseal hyperfunction; Group II with V-type exotropia without overt lower oblique muscle function; Ⅲ group V-type esotropia with oblique function in 14 cases; Ⅳ group V-type esotropia no obvious deviation in 7 cases of oblique; group Ⅰ and group Ⅲ internal and external strabismus correction at the same time, single (double) lateral oblique The patients in group Ⅱ and Ⅳ were treated with vertical and horizontal displacement of horizontal rectus muscle at the same time. Results In group Ⅰ, the difference of squint angle was less than or equal to 4 △ when the original eyelid position -8 △ - + 3 △ was up and down. Ⅱ group original bit position -10 △ - +5 △ up and down gaze angle deviation ≤ 8 △. Ⅲ group original bit in the eye -4 △ - +6 △ up and down gaze when the oblique angle ≤ 4 △. In group Ⅳ, the original eyelid position was -5 △ - + 10 △, the difference between the up and down squint angle was 7 △. Conclusions Two kinds of surgical correction of V-type strabismus have a definite curative effect. The posterior oblique migration possesses obvious effect on vertical displacement of horizontal rectus muscle attachment points, and there is hope to establish binocular single vision function.