The surgical management of esotropia with high AC/A ratio

中国实用眼科杂志 Pub Date : 2017-11-10 DOI:10.3760/CMA.J.ISSN.1006-4443.2017.11.012

De-Jun Zhu, Lin Pang

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Abstract

Objective To determine the effectiveness of strabismus surgery as an alternative treatment for high accommodative convergence/accommodation (AC/A) ratio (convergence excess) esotropia. Methods Sixty-five consecutive children with an AC/A ratio of distance-near disparity of 10 prism diopters (PD) or more were studied in a prospective design. Each patient was treated by recession of both medial rectus muscles for the full amount of esotropia measured at near fixation through the full distance hyperopic correction. The magnitude of esodeviation, the AC/A ratio, and the grade of binocularity were measured before and after strabismus surgery. Results The majority of patients were able to maintain satisfactory ocular alignment after surgery, the alignment rates were 76.3% (after 1week), 82.8% (after 1 month), 85.7% (after 6 months), 92.1% (after 1 year). The grade of binocular fusion or stereopsis improved significantly in all of the patients. Conclusions These results demonstrate that strabismus surgery may be more effective in restoring normal stereopsis and binocular fusion for high AC/A patients. Key words: AC/A; Esotropia; Operation

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高AC/A比内斜视的手术治疗

目的探讨斜视手术治疗高调节收敛/调节(AC/A)比(收敛过度)内斜视的有效性。方法对连续65例AC/A近距视差大于10棱镜屈光度(PD)的儿童进行前瞻性研究。每位患者在近固定时通过全距离远视矫正，通过收缩两侧内侧直肌来治疗内斜视。测量斜视手术前后的内偏程度、AC/A比值和双眼视功能等级。结果大多数患者术后均能保持满意的眼线对准，其对准率分别为76.3%(1周)、82.8%(1个月)、85.7%(6个月)、92.1%(1年)。所有患者的双眼融合或立体视觉评分均有明显改善。结论对于高AC/A的斜视患者，斜视手术可更有效地恢复正常立体视和双目融合。关键词:空调;内斜眼;操作

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中国实用眼科杂志

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