间歇性外斜视合并近视患者手术前后调节集合功能变化的年龄差异分析

Analysis of Age Differences in the Changes of Accommodative Convergence Function before and after Surgery in Patients with Intermittent Exotropia Combined with Myopia

摘要: 目的：对间歇性外斜视合并近视患者手术前后的调节集合功能进行临床分析，探讨不同年龄段间歇性外斜视合并近视青少年行斜视矫正术的疗效。方法：收集2023年7月至2024年12月行单眼手术治疗的间歇性外斜视青少年患者50例，均进行单眼外直肌后徙加内直肌缩短手术治疗，根据患者年龄分为低龄组(4~9岁，25例)及大龄组(10~18岁，25例)。术后随访6月，比较两组术前及术后AC/A、双眼AMP、NRA、PRA的差异。结果：两组AC/A、双眼AMP、NRA术后3月及6月均较术前提高(P < 0.001)，且低龄组高于大龄组(P < 0.05)，两组手术前后PRA比较，差异无统计学意义(P > 0.05)。结论：间歇性外斜视合并近视患者经过手术治疗后，双眼调节集合功能改善，且年龄较小者改善效果更好。

Abstract: Objective: To conduct a clinical analysis of the accommodative convergence function of patients with intermittent exotropia combined with myopia before and after surgery, and to explore the therapeutic efficacy of strabismus correction surgery for adolescents with intermittent exotropia combined with myopia of different age groups. Methods: From July 2023 to December 2024, 50 adolescent patients with intermittent exotropia who underwent unilateral surgery were enrolled. All patients underwent unilateral lateral rectus recession combined with medial rectus resection. The patients were divided into a younger group (4~9 years old, 25 cases) and an older group (10~18 years old, 25 cases) according to their age. Postoperative follow-up was conducted for 6 months. The differences in preoperative and postoperative AC/A, binocular accommodation amplitude (AMP), negative relative accommodation (NRA), and positive relative accommodation (PRA) between the two groups were compared. Results: The AC/A, binocular AMP, and NRA of both groups improved at 3 months and 6 months after surgery compared to before surgery (P < 0.001), and the younger group had higher values than the older group (P < 0.05). There was no statistically significant difference in preoperative and postoperative PRA in either group (P > 0.05). Conclusion: After surgical treatment, the accommodative convergence function of patients with intermittent exotropia combined with myopia improves, and the improvement effect is better in younger patients.