Influence to Recovery of Binocular Vision through Fusion Training in Concomitant Strabismus after Surgery
|Keywords||Concomitant strabismus Synoptophore Binocular fusion Fusiontraining Operation|
ObjectiveTo investigate the preoperative and postoperative fusion function of patients withconcomitant strabismus and the effect of fusion training with synoptophore onpostoperative reconstruction of binocular fusion function.MethodsThe study was approved by the Medical Ethics Committee, and the consents from thepatients and their families were obtained.128patients with concomitant strabismus andwithout binocular fusion by synoptophore in Qingdao Eye Hospital from April2012toOctober2012were included. According to the types of strabismus, patients were dividedinto three groups, group1: intermittent exotropia group2: constant exotropia group3:concomitant esotropia. Data of preoperative and postoperative binocular fusion function:first fusion by Bagolini linear mirror, Worth4lighting test, and synoptophore testing;secondary fusion by synoptophore testing and rotating prism; third fusion by YanShaoming’s random digital stereo vision inspection points, Titmus stereogram andsynoptophore testing. Postoperative1month, patients who still could not rebuild binocularfusion were randomly divided into two groups, group A: fusion training group whorecieved fusion training with synoptophore, group B: control group. Afterwards group Aand B were tested with the above methods.Results86%patients with intermittent exotropia,45%with constant exotropia, and23%with concomitant esotropia can be reconstructed binocular fusion after surgery, and thedifference was statistically significant (P<0.05). The detection rates of binocular fusionwith different inspection methods were different, among which, the detection rates withlinear Bagolini microscopy was the highest, followed by Worth4lighting test andsynoptophore test (P <0.05). After fusion training with synoptophore,37.5%of patients ingroup B accepted foveal fusion, while3.7%in group B did (P <0.05). Recurrence rate inbetween group A and group B was statistically different.Conclusions(1) Concomitant strabismus surgery is useful to rebuild part binocular fusion ofpatients with strabismus. The younger is patient, the longer of duration and the older atsurgery, the lower is the reconstruction rate.(2) Binocular fusion detection rates withdifferent fusion inspection method are different, therefore different inspection methodsshould be used to discover fusion dysfunction in time and to guide the treatment ofstrabismus.(3) Binocular fusion training with synoptophore can help not only reconstructbinocular fusion during the critical period of visual development, but also effectivelyreconstruct binocular fusion, acquire function cure and prevent recurrence of strabismus inpatients over the age of the critical period.