集合不足型间歇性外斜视治疗的研究进展
Research Progress in the Treatment of Convergence Insufficiency-Type Intermittent Exotropia
DOI: 10.12677/acm.2024.1492485, PDF,   
作者: 唐金华：吉首大学医学院，湖南 吉首；彭晓娟*, 石 鹃：吉首大学第一附属医院眼科，湖南 吉首
关键词: 集合不足型间歇性外斜视；非手术治疗；手术治疗；Convergence Insufficiency-Type Intermittent Exotropia； Non-Surgical Treatment； Operative Treatment
摘要: 目前，我国集合不足型间歇性外斜视(CI-IXT)患病率逐年增加，其治疗方法包括手术治疗和非手术治疗，而手术治疗是主要的治疗方式。本文通过回顾分析近年来对于CI-IXT的临床研究及相关成果，从流行病学、发病机制、非手术治疗及手术治疗等方面出发，为CI-IXT的治疗作一综述，希望为临床工作中CI-IXT治疗方案的选择提供帮助。
Abstract: At present, the prevalence rate of convergence insufficiency-type intermittent exotropia (CI-IXT) is increasing year by year in our country. The treatment methods include the operation treatment and non-surgical treatment, while the operation treatment is the main treatment. By reviewing the clinical research and related results of CI-IXT in recent years, this article reviews the treatment of CI-IXT from the aspects of epidemiology, pathogenesis, non-surgical treatment and operative treatment, hoping to provide help for the selection of CI-IXT treatment in clinical work.
文章引用：唐金华, 彭晓娟, 石鹃. 集合不足型间歇性外斜视治疗的研究进展[J]. 临床医学进展, 2024, 14(9): 473-481. https://doi.org/10.12677/acm.2024.1492485

参考文献

[1] Mohney, B.G., Cotter, S.A., Chandler, D.L., Holmes, J.M., Wallace, D.K., Yamada, T., et al. (2019) Three-Year Observation of Children 3 to 10 Years of Age with Untreated Intermittent Exotropia. Ophthalmology, 126, 1249-1260. [Google Scholar] [CrossRef] [PubMed]
[2] 邱晓荣, 柏玉洁. 内直肌斜向缩短联合外直肌后徙术治疗集合不足型外斜视临床观察[J]. 中国斜视与小儿眼科杂志, 2018, 26(4): 27-28.
[3] 楚瑞雪, 王惠, 王飞, 等. 外直肌斜向后徙术矫正儿童集合不足型间歇性外斜视的早期效果分析[J]. 中国斜视与小儿眼科杂志, 2022, 30(1): 33-35+29.
[4] 扶城宾, 何瑞霞, 郭桂花, 等. 双眼外直肌倾斜后徙术治疗集合不足型间歇性外斜视的疗效[J]. 国际眼科杂志, 2021, 21(7): 1249-1252.
[5] Chen, X., Fu, Z., Yu, J., Ding, H., Bai, J., Chen, J., et al. (2015) Prevalence of Amblyopia and Strabismus in Eastern China: Results from Screening of Preschool Children Aged 36-72 Months. British Journal of Ophthalmology, 100, 515-519. [Google Scholar] [CrossRef] [PubMed]
[6] Chen, D., Li, R., Li, X., Huang, D., Wang, Y., Zhao, X., et al. (2020) Prevalence, Incidence and Risk Factors of Strabismus in a Chinese Population-Based Cohort of Preschool Children: The Nanjing Eye Study. British Journal of Ophthalmology, 105, 1203-1210. [Google Scholar] [CrossRef] [PubMed]
[7] Yang, M., Chen, J., Shen, T., Kang, Y., Deng, D., Lin, X., et al. (2016) Clinical Characteristics and Surgical Outcomes in Patients with Intermittent Exotropia. Medicine, 95, e2590. [Google Scholar] [CrossRef] [PubMed]
[8] Chia, A., Roy, L. and Seenyen, L. (2007) Comitant Horizontal Strabismus: An Asian Perspective. British Journal of Ophthalmology, 91, 1337-1340. [Google Scholar] [CrossRef] [PubMed]
[9] Demer, J.L. (2014) Compartmentalization of Extraocular Muscle Function. Eye, 29, 157-162. [Google Scholar] [CrossRef] [PubMed]
[10] 王京辉, 卢炜. 间歇性外斜视术后双眼视功能重建的临床研究[J]. 眼科, 2000, 9(5): 287-291.
[11] 谢文芳, 李俊红. 间歇性外斜视的自然病程与治疗[J]. 国际眼科纵览, 2017, 41(1): 23-27.
[12] Mohney, B.G., Cotter, S.A., Chandler, D.L., Holmes, J.M., Chen, A.M., Melia, M., et al. (2015) A Randomized Trial Comparing Part-Time Patching with Observation for Intermittent Exotropia in Children 12 to 35 Months of Age. Ophthalmology, 122, 1718-1725. [Google Scholar] [CrossRef] [PubMed]
[13] Buck, D., Powell, C.J., Rahi, J., Cumberland, P., Tiffin, P., Taylor, R., et al. (2012) The Improving Outcomes in Intermittent Exotropia Study: Outcomes at 2 Years after Diagnosis in an Observational Cohort. BMC Ophthalmology, 12, Article No. 1. [Google Scholar] [CrossRef] [PubMed]
[14] Suh, Y., Kim, S., Lee, J. and Cho, Y.A. (2006) Conversion of Intermittent Exotropia Types Subsequent to Part-Time Occlusion Therapy and Its Sustainability. Graefe’s Archive for Clinical and Experimental Ophthalmology, 244, 705-708. [Google Scholar] [CrossRef] [PubMed]
[15] Freeman, R.S. and Isenberg, S.J. (1989) The Use of Part-Time Occlusion for Early Onset Unilateral Exotropia. Journal of Pediatric Ophthalmology & Strabismus, 26, 94-96. [Google Scholar] [CrossRef] [PubMed]
[16] Cotter, S.A., Mohney, B.G., Chandler, D.L., Holmes, J.M., Repka, M.X., Melia, M., et al. (2014) A Randomized Trial Comparing Part-Time Patching with Observation for Children 3 to 10 Years of Age with Intermittent Exotropia. Ophthalmology, 121, 2299-2310. [Google Scholar] [CrossRef] [PubMed]
[17] Akbari, M.R., Mirzajani, A., Moeinitabar, M.R., Mirmohammadsadeghi, A., Khorrami-Nejad, M. and Sharbatoghli, L. (2019) The Effect of Alternate Occlusion on Control of Intermittent Exotropia in Children. European Journal of Ophthalmology, 30, 275-279. [Google Scholar] [CrossRef] [PubMed]
[18] Akbari, M.R., Mehrpour, M. and Mirmohammadsadeghi, A. (2021) The Influence of Alternate Part-Time Patching on Control of Intermittent Exotropia: A Randomized Clinical Trial. Graefe’s Archive for Clinical and Experimental Ophthalmology, 259, 1625-1633. [Google Scholar] [CrossRef] [PubMed]
[19] 宋德胜, 钱晶, 程海霞, 等. 间歇性外斜视非手术治疗研究进展[J]. 中华眼视光学与视觉科学杂志, 2022, 24(10): 796-800.
[20] 韦严, 亢晓丽, 赵堪兴. 间歇性外斜视的研究进展[J]. 中华眼科杂志, 2011, 47(11): 1043-1048.
[21] Lavrich, J.B. (2015) Intermittent Exotropia. Current Opinion in Ophthalmology, 26, 375-381. [Google Scholar] [CrossRef] [PubMed]
[22] Brodsky, M.C., Horwood, A.M. and Riddell, P.M. (2015) Intermittent Exotropia. Journal of American Association for Pediatric Ophthalmology and Strabismus, 19, 397-398. [Google Scholar] [CrossRef] [PubMed]
[23] Bayramlar, H., Gurturk, A.Y., Sari, U. and Karadag, R. (2016) Overcorrecting Minus Lens Therapy in Patients with Intermittent Exotropia: Should It Be the First Therapeutic Choice? International Ophthalmology, 37, 385-390. [Google Scholar] [CrossRef] [PubMed]
[24] Chen, A.M., Erzurum, S.A., Chandler, D.L., Hercinovic, A., Melia, B.M., Bhatt, A.R., et al. (2021) Overminus Lens Therapy for Children 3 to 10 Years of Age with Intermittent Exotropia. JAMA Ophthalmology, 139, 464-476. [Google Scholar] [CrossRef] [PubMed]
[25] Scheiman, M., Mitchell, G.L., Cotter, S.A., et al. (2015) Convergence Insufficiency Treatment Trial—Attention and Reading Trial (CITT-ART): Design and Methods. Vision Development and Rehabilitation, 1, 214-228.
[26] Scott, A.B. (1980) Botulinum Toxin Injection into Extraocular Muscles as an Alternative to Strabismus Surgery. Journal of Pediatric Ophthalmology & Strabismus, 17, 21-25. [Google Scholar] [CrossRef] [PubMed]
[27] 李苑, 吴晓, 王京辉. A型肉毒毒素治疗儿童间歇性外斜视的近期效果[J]. 眼科, 2008, 17(2): 126-129.
[28] Saunte, J.P. and Christensen, T. (2014) Improvement in Reading Symptoms Following Botulinum Toxin an Injection for Convergence Insufficiency Type Intermittent Exotropia. Acta Ophthalmologica, 93, e391-e392. [Google Scholar] [CrossRef] [PubMed]
[29] Su, H., Fu, J., Wu, X., Sun, A., Zhao, B. and Hong, J. (2022) Comparison of Botulinum Toxin Type a with Surgery for the Treatment of Intermittent Exotropia in Children. BMC Ophthalmology, 22, Article No. 53. [Google Scholar] [CrossRef] [PubMed]
[30] Hofsli, M., Torp-Pedersen, T.E., Sepstrup Lønkvist, C. and Saunte, J.P. (2023) Botulinum Toxin an Injection for Convergence Insufficiency. Journal of Pediatric Ophthalmology & Strabismus, 60, 108-113. [Google Scholar] [CrossRef] [PubMed]
[31] Little, J. (2018) Vision in Children with Autism Spectrum Disorder: A Critical Review. Clinical and Experimental Optometry, 101, 504-513. [Google Scholar] [CrossRef] [PubMed]
[32] 王利华, 赵堪兴. 间歇性外斜视治疗中的热点问题[J]. 中华眼科杂志, 2015, 51(6): 465-469.
[33] Burian, H.M. and Spivey, B.E. (1965) The Surgical Management of Exodeviations. American Journal of Ophthalmology, 59, 603-620. [Google Scholar] [CrossRef] [PubMed]
[34] Wang, B., Wang, L., Wang, Q. and Ren, M. (2014) Comparison of Different Surgery Procedures for Convergence Insufficiency-Type Intermittent Exotropia in Children. British Journal of Ophthalmology, 98, 1409-1413. [Google Scholar] [CrossRef] [PubMed]
[35] von Noorden, G.K. (1976) Resection of Both Medial Rectus Muscles in Organic Convergence Insufficiency. American Journal of Ophthalmology, 81, 223-226. [Google Scholar] [CrossRef] [PubMed]
[36] 李秋慧, 黎昌江, 王兆堰, 等. 两种术式对小儿集合不足型间歇性外斜视患儿视觉功能影响[J]. 临床军医杂志, 2022, 50(2): 188-190.
[37] Biedner, B. (1997) Treatment of Convergence Insufficiency by Single Medial Rectus Muscle Slanting Resection. Ophthalmic Surgery, Lasers and Imaging Retina, 28, 347-348. [Google Scholar] [CrossRef] 
[38] 李志刚, 荣军博, 许丽敏, 等. 单眼水平直肌后徙联合缩短术与内直肌斜向缩短术治疗集合不足型外斜视的疗效对比[J]. 中华眼视光学与视觉科学杂志, 2018, 20(5): 279-285.
[39] Choi, D.G. and Rosenbaum, A.L. (2001) Medial Rectus Resections with Adjustable Suture for Intermittent Exotropia of the Convergence Insufficiency Type. Journal of American Association for Pediatric Ophthalmology and Strabismus, 5, 13-17. [Google Scholar] [CrossRef] [PubMed]
[40] 吴其正, 王晓明, 王利华, 等. 单眼外直肌后徙术治疗儿童间歇性外斜视的疗效[J]. 中华眼视光学与视觉科学杂志, 2012, 14(1): 34-37.
[41] Weakley, D.R. and Stager, D.R. (1993) Unilateral Lateral Rectus Recessions in Exotropia. Ophthalmic Surgery, Lasers and Imaging Retina, 24, 458-460. [Google Scholar] [CrossRef] 
[42] Menon, V., Singla, M.A., Saxena, R. and Phulijele, S. (2010) Comparative Study of Unilateral and Bilateral Surgery in Moderate Exotropia. Journal of Pediatric Ophthalmology & Strabismus, 47, 288-291. [Google Scholar] [CrossRef] [PubMed]
[43] 王嘉璐, 亢晓丽, 董凌燕, 等. 外直肌倾斜后徙术与外直肌后徙术治疗集合不足型外斜视的效果比较[J]. 中华眼视光学与视觉科学杂志, 2020, 22(12): 902-907.
[44] Ma, L., Yang, L. and Li, N. (2016) Bilateral Lateral Rectus Muscle Recession for the Convergence Insufficiency Type of Intermittent Exotropia. Journal of American Association for Pediatric Ophthalmology and Strabismus, 20, 194-196.e1. [Google Scholar] [CrossRef] [PubMed]
[45] Al-Haddad, C., Ismail, K., Houry, R., Al Sayyid, S. and El Moussawi, Z. (2020) Recurrence of Intermittent Exotropia after Bilateral Lateral Rectus Recession. Middle East African Journal of Ophthalmology, 27, 123-127. [Google Scholar] [CrossRef] [PubMed]
[46] Farid, M.F. and Abdelbaset, E.A. (2017) Surgical Outcomes of Three Different Surgical Techniques for Treatment of Convergence Insufficiency Intermittent Exotropia. Eye, 32, 693-700. [Google Scholar] [CrossRef] [PubMed]
[47] Chun, B.Y. and Kang, K.M. (2015) Early Results of Slanted Recession of the Lateral Rectus Muscle for Intermittent Exotropia with Convergence Insufficiency. Journal of Ophthalmology, 2015, 1-5. [Google Scholar] [CrossRef] [PubMed]
[48] 张萌, 路素华, 刘慧, 等. 间歇性外斜视不同术式的效果比较[J]. 中国实用眼科杂志, 2011, 29(4): 396-398.
[49] 孙卫锋. 对小度数集合不足型间歇性外斜视手术疗效分析[J]. 中国实用眼科杂志, 2011, 29(3): 269-271.
[50] Vadhul, R., Rogers, J.D. and Rogers, D.L. (2024) Outcomes for Intermittent Exotropia Using Three Common Surgical Approaches. Journal of Pediatric Ophthalmology & Strabismus, 61, 287-290. [Google Scholar] [CrossRef] [PubMed]
[51] 李秀贵, 冯清霞. 双眼外直肌后徙术治疗儿童间歇性外斜视的效果观察[J]. 中华眼外伤职业眼病杂志, 2020, 42(9): 670-675.
[52] 王丹, 杨素红. 单眼内直肌截除联合外直肌后徙术和双眼内直肌截除术治疗儿童集合不足型间歇性外斜视的疗效分析[J]. 中国斜视与小儿眼科杂志, 2020, 28(2): 28-31+7.
[53] Kraft, S.P., Levin, A.V. and Enzenauer, R.W. (1995) Unilateral Surgery for Exotropia with Convergence Weakness. Journal of Pediatric Ophthalmology & Strabismus, 32, 183-187. [Google Scholar] [CrossRef] [PubMed]
[54] 孙卫锋, 徐红佳, 韩惠芳, 等. 改良外斜视矫正术治疗儿童小度数集合不足型间歇性外斜视的临床观察[J]. 中国斜视与小儿眼科杂志, 2021, 29(1): 18-20.
[55] Shafik, H.M., Eldesouky, M.A., Elbakary, M.A. and Elbedewy, H.A. (2022) Unilateral Surgery for Pediatric Sensory Exotropia: Clinical Characteristics and Surgical Results. BMC Ophthalmology, 22, Article No. 507. [Google Scholar] [CrossRef] [PubMed]
[56] Yang, X., Man, T.T., Tian, Q.X., et al. (2014) Long-Term Postoperative Outcomes of Bilateral Lateral Rectus Recession vs Unilateral Recession-Resection for Intermittent Exotropia. International Journal of Ophthalmology, 7, 1043-1047.
[57] Snir, M., Axer-Siegel, R., Shalev, B., Sherf, I. and Yassur, Y. (1999) Slanted Lateral Rectus Recession for Exotropia with Convergence Weakness. Ophthalmology, 106, 992-996. [Google Scholar] [CrossRef] [PubMed]
[58] 曾俊, 刘陇黔. 间歇性外斜视术后中远期眼位的相关因素分析[J]. 国际眼科杂志, 2020, 20(8): 1448-1451.
[59] 赵梦瑶. 双眼外直肌倾斜后徙术治疗集合不足型间歇性外斜视的疗效[J]. 临床研究, 2022, 30(8): 52-55.
[60] Kwon, J.M. and Lee, S.J. (2019) Long-Term Results of Slanted Recession of Bilateral Lateral Rectus Muscle for Intermittent Exotropia with Convergence Insufficiency. Korean Journal of Ophthalmology, 33, 353-358. [Google Scholar] [CrossRef] [PubMed]

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