Clinical Study On Binocular Vision Changes Before、 And After Comitant Strabismus Surgery

Objective: Evaluate the effect of different types of strabismus on the after-surgeryrecovery of binocular vision and study the recovery regularity by observing the changesin binocular vision of comitant strabismus patients before and after strabismus surgery.Methods: Select72cases of comitant strabismus who were treated in our hospitalfrom October2010to December2011including41male and31female patients whoseages were from3to36.They were divided into three groups: Group1, constantnon-accommodative esotropia13cases; Group2, intermittent exotropia27cases; Group3, constant exotropia21cases; Group4, constant exotropia with inferior obliquehyperfunction11cases. Patients received routine examinations and refractionexaminations of eyes. Distance and near degree of tropia were measured byprism-covering approach. The three-degree visual function were examined bysynotophore and the stereoacuity was examined by Shaoming Yan’s stereogram. Aboveexamination data were collected and recorded before surgery, on the first day of surgery,the seventh day, the first month, and the third month after surgery. This study is basedon these data.Results:1. Comparison on binocular visual of different types of strabismus:⑴Preoperative general condition: There were no statistically significantdifferences in the operation age, the onset age and the degree of deviation among thefour groups (P>0.05). There were no statistically significant differences in preoperativesimultaneous perception, fusion, distance and near stereoacuity among the four groups(P>0.05).⑵Postoperative simultaneous perception: Simultaneous perception recovery ofGroup2(23cases,85.2%) was better than that of Group1(7cases,53.8%), Group3(12cases,57.1%), and Group4(6cases,54.5%). The differences were statistically significant (P<0.05).⑶Postoperative fusion: Fusion recovery of Group2(19cases,70.4%,19.3°±3.1°)was better than that of Group1(5cases,38.5%,6.3°±4.8°), Group3(9cases,42.9%,14.1°±3.7°), and Group4(3cases,27.3%,12.4°±7.5°). The differences werestatistically significant (P<0.05).⑷Postoperative distance stereoacuity: Distance stereoacuity recovery of Group2(8cases,29.6%) was better than that of Group1(0cases). The differences werestatistically significant (P<0.05).⑸Postoperative near stereoacuity: Near stereoacuity recovery of Group2(24cases,88.9%) was better than that of Group1(5cases,38.5%), Group3(11cases,52.4%), and Group4(8cases,72.7%). The differences were statistically significant(P<0.05).2. The comparison on binocular vision after surgery and before surgery:Three-degree visual function and near stereoacuity of patients improved obviouslyafter surgery (P<0.05). There was no significant difference between the first day and theseventh day, nor between the first month and the third month after surgery (P>0.05).Conclusion:1. Patients with comitant strabismus suffered from different degree ofdegeneration of binocular vision.2. After surgery, three-degree visual function and near stereoacuity of patientswere improved obviously comparing to the conditions before surgery. Surgery is aneffective method to recover and rebuid binocular vision3. Binocular vision recovers better for patients with intermittent exotropia thanthose with constant non-accommodative esotropia, constant exotropia, or constantexotropia with inferior oblique hyperfunction. Constant non-accommodative esotropia,constant exotropia and constant exotropia with inferior oblique hyperfunction producedthe same effect on binocular vision in distance.4. There was no significant difference between the data collected on the firstmonth and those recorded on the third month after strabismus surgery. The recovery ofbinocular vision became stable after l month from the surgery.