间歇性外斜视手术前后立体视影响因素及手术时机的探讨
|
摘要
目的：研究间歇性外斜视手术前立体视功能损害程度、术后立体视功能重建及其影响因素。探讨间歇性外斜视的最佳手术时机。
方法：病例对照研究,非匹配型。2009年10月～2010年1月在天津市眼科医院筛选间歇性外斜视患者。按年龄分为3组,组1：4岁≤年龄<8岁,组2：8岁≤年龄<18岁,组3：年龄≥18岁,每组30例,其中男55例,女35例。基本型66例,集合不足型24例,假性分开过强型并入基本型。每位患者术前、术后6周及以上复诊时检查斜视度、眼球运动,用Worth四点灯检查视远的中心凹融合功能,同视机猫捉蝴蝶画片检查视远的周边融合功能；用Titmus、Frisby、颜少明编著《数字化立体视觉检查图》(Digital Stereoscopic Test Charts, DSTC)检查近立体视觉；用同视机随机点立体视画片(random-dot stereograms, RDS)、OPTEC6500、FD2 (Frisby Davis Distance Stereotest)检查远立体视觉。比较各年龄组术前立体视觉损害情况、术后立体视觉重建情况及影响其恢复的相关因素。
结果：(1)、术前Frisby、Titmus:各年龄组间无差别(P>0.05)。DSTC：组2立体视视锐度小于其它两组,后二者无差别。术前OPTEC6500、同视机RDS：组2立体视视锐度小于其它两组,后两组无差别。术前FD2：组2、组1、组3立体视视锐度依次增大。发现年龄：组1最小,其余两组无差别。病程随年龄组别依次增长,斜视度依次增大。(2)、术后Frisby、Titmus:各年龄组间无差别(P>0.05)。术后DSTC：组1立体视视锐度大于其它两组,后两组无差别。术后OPTEC6500、FD2：各年龄组间无差别。同视机RDS：组2立体视视锐度小于其它两组,后二者无差别。(3)、手术前后立体视视锐度Titmus无变化,Frisby、DSTC、OPTEC6500、同视机RDS、FD2明显改善。(4)术后视近眼位过矫、欠矫均会影响术后近立体视的重建,以过矫影响最大,欠矫影响相对较小；术后视远眼位过矫、欠矫对术后远立体视重建的影响,不同检查方法得出结论不同：同视机RDS结果是均没有影响；OPTEC6500结果是均有影响；FD2结果是欠矫没有影响,过矫有影响。术后远立体视视锐度同视机RDS结果与病程呈正相关关系,OPTEC6500、FD2结果均与发现年龄呈负相关关系,三者均与轻度眼球运动异常、近斜视度、远斜视度无相关关系,同视机RDS、FD2结果均与术前远周边融合范围呈负相关关系,OPTEC6500结果与术前远中心凹融合功能呈负相关关系。
结论：(1)、术前间歇性外斜视近立体视损坏轻,远立体视损坏严重,发现年龄越早,病程越长损坏越重。(2)、术后远近立体视觉均有改善,但以远立体视改善明显。(3)、远立体视和融合功能减退可作为病情进展的参考指标,对其预后估计和疗效评价有重要意义。(4)、不同立体视觉检查仪器侧重于检查双眼视功能的不同方面,各有优缺点,应通过不同方面的检查给予综合评估。(5)、发现年龄越大、病程越短的术后立体视重建得越好。(6)、成功的矫正手术可明显改善立体视觉,过矫可阻碍立体视的重建。
Objective:To investigate the damage of the stereopsis in intermittent exotropia pre-operation, the reconstruction of stereopsis post-operation and effect factors.To opproach the optimal timing of surgery.
Methods:Case control study, non-match type.To collect the patients with intermittent exotropia in Tianjin Eye Hospital from Oct.2009 to Jan.2010.All the cases (female 35 cases and male 55 cases) were classified 3 groups, in which had 30 cases in each group, age between 4 to 8 years old in group 1, age between 8 to 18 years old in group 2 and age beyond 18 years old in group 3.There were 66 cases with basic type and 24 cases with convergence insufficient type. Pseudo-divergence excess was combined with basic intermittent exotropia. Pre- and Post- operation examinations to each patient include the tests of ocular alignment, assessment of eye movements, Worth four-dot test at 6 meters for central fusion, synoptophore with the picture of cat and butterfly for peripheral fusion, Titmus, Frisby, Digital Stereoscopic Test Charts (DSTC) composed by Yan Shaoming, synoptophore with the Picture of RDS triburated by Tianjin Eye Hospital. To compare the damage of stereopsis, the reconstruction of stereopsis and its influencing factors among three groups.
Results:(1).There was no statistically significant difference between the stereoacuity tested by Frisby arid Titmus before surgery (P>0.05). The average stereoacuity tested by DSTC, OPTEC6500 and synoptophore with RDS in group 2 was respectively less than that in other groups, however, there was no statistically significant difference between the group 1 and group 3. Stereoacuity tested by FD2 increased gradually in turn of group2, group 1 and group 3. Onsetting age in group 1 was the mimimus, and there was no statistically significant difference between the other groups.The course of disease became longer gradually with increasing average age of every group, and the deviation became larger gradually at the same time. (2). There was no statistically significant difference among the Post-operation stereoacuity of three goups tested by Frisby, Titmus, OPTEC6500, and FD2 respectively (P>0.05). Stereoacuity tested by DSTC in group 1 was more than the other groups. However, there was no statistically significant difference between the other groups. Stereoacuity tested by synoptophore with RDS in grouP 2 was less than the other groups. However, there was no statistically significant difference between the other groups. (3). There is no chang Post-operation in Titmus, but there were significantly differeces in Frisby, DSTC, OPTEC6500, synoptophore with RDS and FD2 between pre- and post -operation. (4).Both surgical overcorrection and undercorrection hindered stereopsis reconstruction. Overcorrection did the more, while undercorrection did the less. Postoperative distant stereoacuity tested by synoptophore with RDS was positive correlative to course of disease and distant stereoacuity tested by OPTEC6500 and FD2 was negative correlative to onset age. All tests were not correlative to ocular movement mild disorder and amplitude of diviation. Stereoacuity tested by synoptophore with RDS and FD2 was negative correlative to pre-operative peripheral fusion range, and stereoacuity tested by OPTEC6500 was negative correlative to preoperative central fusion.
Conclusion:(1).Distant stereopsis is damaged severely, while near stereopsis is damaged lightly. Stereopsis is damaged more severely with earlier age of onset and longer course of disease. (2).Both near and distant stereopsis improve after surgery, especially distant stereopsis. (3).Reduction of distance stereopsis can labell the progression of intermittent exotropia, so stereopsis is important to estimate prognosis and treatment effect of surgery. (4).Different stereoscopic tests have particular emphasis on different aspects of binocular vision. Therefore we should assess synthetically binocular vision by different tests. (5). Postoperative stereopsis is better when age of onset is older, and course of disease is shorter. (6). A successful surgery can improve significantly stereopsis, but overcorrection hinders the postoperative stereopsis reconstruction.
方法：病例对照研究,非匹配型。2009年10月～2010年1月在天津市眼科医院筛选间歇性外斜视患者。按年龄分为3组,组1：4岁≤年龄<8岁,组2：8岁≤年龄<18岁,组3：年龄≥18岁,每组30例,其中男55例,女35例。基本型66例,集合不足型24例,假性分开过强型并入基本型。每位患者术前、术后6周及以上复诊时检查斜视度、眼球运动,用Worth四点灯检查视远的中心凹融合功能,同视机猫捉蝴蝶画片检查视远的周边融合功能；用Titmus、Frisby、颜少明编著《数字化立体视觉检查图》(Digital Stereoscopic Test Charts, DSTC)检查近立体视觉；用同视机随机点立体视画片(random-dot stereograms, RDS)、OPTEC6500、FD2 (Frisby Davis Distance Stereotest)检查远立体视觉。比较各年龄组术前立体视觉损害情况、术后立体视觉重建情况及影响其恢复的相关因素。
结果：(1)、术前Frisby、Titmus:各年龄组间无差别(P>0.05)。DSTC：组2立体视视锐度小于其它两组,后二者无差别。术前OPTEC6500、同视机RDS：组2立体视视锐度小于其它两组,后两组无差别。术前FD2：组2、组1、组3立体视视锐度依次增大。发现年龄：组1最小,其余两组无差别。病程随年龄组别依次增长,斜视度依次增大。(2)、术后Frisby、Titmus:各年龄组间无差别(P>0.05)。术后DSTC：组1立体视视锐度大于其它两组,后两组无差别。术后OPTEC6500、FD2：各年龄组间无差别。同视机RDS：组2立体视视锐度小于其它两组,后二者无差别。(3)、手术前后立体视视锐度Titmus无变化,Frisby、DSTC、OPTEC6500、同视机RDS、FD2明显改善。(4)术后视近眼位过矫、欠矫均会影响术后近立体视的重建,以过矫影响最大,欠矫影响相对较小；术后视远眼位过矫、欠矫对术后远立体视重建的影响,不同检查方法得出结论不同：同视机RDS结果是均没有影响；OPTEC6500结果是均有影响；FD2结果是欠矫没有影响,过矫有影响。术后远立体视视锐度同视机RDS结果与病程呈正相关关系,OPTEC6500、FD2结果均与发现年龄呈负相关关系,三者均与轻度眼球运动异常、近斜视度、远斜视度无相关关系,同视机RDS、FD2结果均与术前远周边融合范围呈负相关关系,OPTEC6500结果与术前远中心凹融合功能呈负相关关系。
结论：(1)、术前间歇性外斜视近立体视损坏轻,远立体视损坏严重,发现年龄越早,病程越长损坏越重。(2)、术后远近立体视觉均有改善,但以远立体视改善明显。(3)、远立体视和融合功能减退可作为病情进展的参考指标,对其预后估计和疗效评价有重要意义。(4)、不同立体视觉检查仪器侧重于检查双眼视功能的不同方面,各有优缺点,应通过不同方面的检查给予综合评估。(5)、发现年龄越大、病程越短的术后立体视重建得越好。(6)、成功的矫正手术可明显改善立体视觉,过矫可阻碍立体视的重建。
Objective:To investigate the damage of the stereopsis in intermittent exotropia pre-operation, the reconstruction of stereopsis post-operation and effect factors.To opproach the optimal timing of surgery.
Methods:Case control study, non-match type.To collect the patients with intermittent exotropia in Tianjin Eye Hospital from Oct.2009 to Jan.2010.All the cases (female 35 cases and male 55 cases) were classified 3 groups, in which had 30 cases in each group, age between 4 to 8 years old in group 1, age between 8 to 18 years old in group 2 and age beyond 18 years old in group 3.There were 66 cases with basic type and 24 cases with convergence insufficient type. Pseudo-divergence excess was combined with basic intermittent exotropia. Pre- and Post- operation examinations to each patient include the tests of ocular alignment, assessment of eye movements, Worth four-dot test at 6 meters for central fusion, synoptophore with the picture of cat and butterfly for peripheral fusion, Titmus, Frisby, Digital Stereoscopic Test Charts (DSTC) composed by Yan Shaoming, synoptophore with the Picture of RDS triburated by Tianjin Eye Hospital. To compare the damage of stereopsis, the reconstruction of stereopsis and its influencing factors among three groups.
Results:(1).There was no statistically significant difference between the stereoacuity tested by Frisby arid Titmus before surgery (P>0.05). The average stereoacuity tested by DSTC, OPTEC6500 and synoptophore with RDS in group 2 was respectively less than that in other groups, however, there was no statistically significant difference between the group 1 and group 3. Stereoacuity tested by FD2 increased gradually in turn of group2, group 1 and group 3. Onsetting age in group 1 was the mimimus, and there was no statistically significant difference between the other groups.The course of disease became longer gradually with increasing average age of every group, and the deviation became larger gradually at the same time. (2). There was no statistically significant difference among the Post-operation stereoacuity of three goups tested by Frisby, Titmus, OPTEC6500, and FD2 respectively (P>0.05). Stereoacuity tested by DSTC in group 1 was more than the other groups. However, there was no statistically significant difference between the other groups. Stereoacuity tested by synoptophore with RDS in grouP 2 was less than the other groups. However, there was no statistically significant difference between the other groups. (3). There is no chang Post-operation in Titmus, but there were significantly differeces in Frisby, DSTC, OPTEC6500, synoptophore with RDS and FD2 between pre- and post -operation. (4).Both surgical overcorrection and undercorrection hindered stereopsis reconstruction. Overcorrection did the more, while undercorrection did the less. Postoperative distant stereoacuity tested by synoptophore with RDS was positive correlative to course of disease and distant stereoacuity tested by OPTEC6500 and FD2 was negative correlative to onset age. All tests were not correlative to ocular movement mild disorder and amplitude of diviation. Stereoacuity tested by synoptophore with RDS and FD2 was negative correlative to pre-operative peripheral fusion range, and stereoacuity tested by OPTEC6500 was negative correlative to preoperative central fusion.
Conclusion:(1).Distant stereopsis is damaged severely, while near stereopsis is damaged lightly. Stereopsis is damaged more severely with earlier age of onset and longer course of disease. (2).Both near and distant stereopsis improve after surgery, especially distant stereopsis. (3).Reduction of distance stereopsis can labell the progression of intermittent exotropia, so stereopsis is important to estimate prognosis and treatment effect of surgery. (4).Different stereoscopic tests have particular emphasis on different aspects of binocular vision. Therefore we should assess synthetically binocular vision by different tests. (5). Postoperative stereopsis is better when age of onset is older, and course of disease is shorter. (6). A successful surgery can improve significantly stereopsis, but overcorrection hinders the postoperative stereopsis reconstruction.
引文
[1]Saunders RA, Trivedi RH. Sensory results after lateral rectus muscle recession for intermittent exotropia operated before two years of age [J].J AAPOS,2008,12 (2):132-135.
[2]Pratt-Johnson JA, Barlow JM. Tillson G.Early surgery in intermittent exotropia [J].Am J Ophthalmol,1977,84(5):689-694.
[3]Asjes-Tydeman WL, Groenewoud H, van der Wilt GJ.Timing of surgery for primary exotropia in children [J]. Strabismus,2006,14(4):191-197.
[4]李济华,张玉环,韩振俊.间歇性外斜视手术治疗的临床观察[J].山东医大基础医学院学报,2000,14(5)：288-289.
[5]Yang CQ, Shen Y, Gu YS, Han W.Clinical investigation of surgery for intermittent exotropia [J]. J Zhejiang Univ Sci B,2008,9(6):470-473.
[6]Richard JM, Parks MM. Intermittent exotropia. Surgical results in different age groups [J].Ophthalmology,1983 (90):1172-1177.
[7]Ekdawi NS, Nusz KJ, Diehl NN, Mohney BG.Postoperative outcomes in children with intermittent exotropia from a population-based cohort[J].J AAPOS, 2009,13(1):4-7.
[8]数字化立体视觉检查图[M],颜少明,北京：人民卫出版社,2006,14-16.
[9]Julesz B.Binocular depth perception without familiarity cues [J].Science,1964,145(7)：356-362.
[10]Read J. Early computational processing in binocular vision and depth perception [J].Prog Biophys Mol Biol,2005,87(1):77-108.
[11]Nusz KJ, Mohney BG, Diehl NN.The Course of Intermittent Exotropia in a population-Based Cohort Ophthalmology [J].2006,113(7):1154-1158.
[12]von Noorden, GK. Binocular vision and ocular motility:theory and management of strabismus [M],6th ed. St. Louis, Mosby.Inc,2002:356-372.
[13]Leske DA, Holmes JM. Maximum Angle of Horizontal Strabismus Consistent with True Stereopsis [J].J AAPOS 2004(8):28-34.
[14]Holmes JM, Leske DA.Monocular clues in tests of stereoacuity [A]. In:Pritchard C. Transactions IX International Orthoptic Congress[C]. Nurnberg, Germany: Berufsverband der Orthoptistinnen Deutchlands Ev,1999:103-106.
[15]Simons K, Elhatton K.Artifacts in fusion and stereopsis testing based on red/green dichoptic image separation [J]. J Pediatr Ophthalmol Strabismus, 1994,31(5):290-297.
[16]Cornforth LL, Johnson BL, Kohl P, Roth N. Chromatic imbalance due to commonly used red-green filters reduces accuracy of stereoscopic depth perception [J]. Am J Optom Physiol Opt,1987,64(11):842-845.
[17]Wilcox LM, Robert F. Hess RF. When stereopsis does not improve with increasing contrast [J]. Vision Research,1998 (38):3671-3679.
[18]Jimenez JR,Rubino M, et al.Influence of the luminance signal and red-green and yellow-blue opponent chromatic signals in figural-stimuli stereograms [J]. Optom Vis Sci,1995,72(9):649-655.
[19]Osuobeni EP. Effect of chromatic aberration on isoluminance stereothreshold [J]. Optom Vis Sci,1991,68(7):552-555.
[20]Frisby JP,Davis H.Frisby Davis Distance Stereotest,Test Design & Test Instructions,Edition 4,2007,20.
[21]Holmes JM, Fawcett SL. Testing distance stereoacuity with the Frisby-Davis 2 (FD2) test [J]. Am J Ophthalmol,2005,139(1):193-195.
[22]Adams WE, Hrisos S, Richardson S, Davis H, Frisby JP, Clarke MP. Frisby Davis distance stereoacuity values in visually normal children [J]. Br J Ophthalmol,2005,89(11):1438-1441.
[23]Hong SW, Park SC. Development of distant stereoacuity in visually normal children as measured by the Frisby-Davis distance stereotest [J].Br J Ophthalmol, 2008,92(9):1186-1189.
[24]Holmes JM, Birch EE, Leske DA, Fu VL.Mohney BGNew tests of distance stereoacuity and their role in evaluating intermittent exotropia [J].Ophthalmology, 2007,114(6):1215-1220.
[25]Leske DA, Birch EE, Holmes JM. Real depth vs randot stereotests [J]. Am J Ophthalmol,2006,142(4):699-701.
[26]Fawcett SL. An evaluation of the agreement between contour-based circles and random dot-based near stereoacuity tests [J]. J AAPOS,2005,9(6):572-578.
[27]Rose D, Price E. Functional separation of global and local stereopsis investigated by cross-adaptation [J]. Neuro Psychologia,1995,33(3):269-274.
[28]Wang J, Hatt SR,O'Connor AR, Drover JR, Adams R, Birch EE, Holmes JM. Final version of the Distance Randot Stereotest:normative data,reliability,and validity[J]. J AAPOS,2010,14(2):142-146.
[29]胡聪,黄欣,刘桂香,李慧,杨先,韩兵.正常和间歇性外斜视儿童立体视的研究[J].中华眼科杂志,2002,38(8)：452-456.
[30]王霁雪,宋跃,杨隆艳.间歇性外斜视患者远距离立体视的临床特点[J].眼视光学杂,2005,7(3)：157-161.
[31]吴奇志,吴晓,卢炜,王京辉.间歇性外斜视手术前后双眼视觉的临床研究[J].中华眼科杂志2007,43(11)：968-971.
[32]Adams WE, Leske DA, Hatt SR, Mohney BG, Birch EE, Weakley DR, Holmes JM.Improvement in distance stereoacuity following surgery for intermittent exotropia[J].J AAPOS,2008,12(2):141-144.
[33]Sharma P, Saxena R, Narvekar M, Gadia R, Menon V. Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia. Indian J Ophthalmol,2008,56(2):121-125.
[34]卢炜,王京辉.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—290.
[35]刘垠,戴鸿斌,宋天勤.远立体视测定对间歇性外斜视手术时机选择的临床观察[J].中国斜视与小儿眼科杂志,2000,8(4)：152-154.
[36]Fawcett SL, Stager DR Sr, Felius J.Factors influencing stereoacuity outcomes in adults with acquired strabismus [J]. Am J Ophthalmol,2004,138(6):931-935.
[37]中华眼科学会全国儿童弱视斜视防治学组.中国斜视与小儿眼科杂志,1996,4(4)：145.
[38]卢炜,王京辉,李林.间歇性外斜视手术欠矫与过矫对立体视锐度影响的临床观察[J].中国斜视与小儿眼科杂志,2007,15(3)：103-105.
[39]郭静秋,臧英芬,甘晓玲.儿童立体视的成熟期及几种检查法的比较[J].北京医科大学学报,1993,25(1)：24-26.
[40]李少敏,甘晓玲,郭静秋.立体视锐度的临床检查及评价中国斜视与小儿眼科杂志[J].1994,26(4)：156-159.
[41]Romano PE, Romano JA, Puklin JE. Stereoacuity development in children with normal binocular single vision [J]. Am J Ophthalmol,1975,79(6):966-971.
[42]张伟赵堪兴.间歇性外斜视手术前后的立体视功能及手术时机探讨[J].眼科新进展,2002,22(5)：337-338.
[43]Yildirim C, Mutlu FM, Chen Y, Altinsoy HI.Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery [J].. Am J Ophthalmol,1999,128(2): 222-230.
[44]Mohney BG, Holmes JM. An office-based scale for assessing control in intermittent exotropia [J]. Strabismus,2006(3),14:147-150.
[45]American Academy of Ophthalmology.Basic and clinical science course, pediatric Ophthalmology and Strabismus [M].Section6,2004-2005,107.
[46]Arnoldi KA,Reynolds JD.Assessment of amplitude and control of the distance deviation in intermittent exotropia[J]. J Pediatr Ophthalmol Strabismus,2008, 45(3):150-153.
[47]Haggerty H, Richardson S, Hrisos S, Strong NP, Clarke MP.The Newcastle control score:a new method of grading the severity of intermittent distance exotropia [J]. Br J Ophthalmol 2004,88(2):233-235.
[48]Stathacopoulos RA, Rosenbaum AL, Zanoni D, Stager DR, McCall LC, Ziffer AJ, Everett M. Distance stereoacuity. Assessing control in intermittent exotropia [J]. Ophthalmology,1993,100(4):495-500.
[49]Buck D, Clarke MP, Haggerty H, Hrisos S,Powell C, Sloper J, Strong NP.Grading the severity of intermittent distance exotropia:the revised Newcastle Control Score [J]. Br J Ophthalmol,2008,92(4):577.
[50]Cumming BG. An unexpected specialization for horizontal disparity in primate primary visual cortex [J]. Nature,2002,418(6898):633-636.
[1]Friedman DS, Repka MX, Katz J, Giordano L, Ibironke J, Hawse P, Tielsch JM. Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study [J].Ophthalmology,2009,116(11):2128-2134.
[2]Govindan M, Mohney BG, Diehl NN, Burke JP.Incidence and types of childhood exotropia:a population-based study [J]. Ophthalmology,2005,112(1):104-108.
[3]Chia A, Seenyen L, Long QB.A retrospective review of 287 consecutive children in singapore presenting with intermittent exotropia[J].J AAPOS, 2005,9(3):257-263.
[4]Yu CB, Fan DS, Wong VW, Wong CY, Lam DS. Changing patterns of strabismus: a decade of experience in Hong Kong [J]. Br J Ophthalmol,2002,86(8):854-856.
[5]王京辉,卢炜.共同性外斜视各类型分布的临床观察[J].眼科,2006,15(5)：331-334.
[6]Mohney BG.Common forms of childhood strabismus in an incidence cohort [J]. Am J Ophthalmol,2007,144(3):465-467.
[7]杨美琼,黄灵聪.厦门市8421名4～6岁儿童眼病调查[J].中国儿童保健杂志,2005,13(2)：171.
[8]Jenkins R. Demograhics:geographic variations in the prevalence and management of exotropia [J]. Am Orthopt J,1992(42):82.
[9]李凤鸣.中华眼科学[M].第二版北京：人民卫生出版社,2005：2725-2730.
[10]Nusz KJ, Mohney BG, Diehl NN.Female predominance in intermittent exotropia [J].Am J Ophthalmol,2005,140(3):546-547.
[11]Nusz KJ, Mohney BG, Diehl NN. The course of intermittent exotropia in a population-based cohort [J]. Ophthalmology,2006,113(7):1154-1158.
[12]von Noorden, GK. Binocular vision and ocular motility:theory and management of strabismus [M],6th ed. St. Louis, Mosby.Inc,2002,134-152.
[13]牛兰俊.斜视新概念[M].北京：北京医科大学、中国协和医科大学联合出版社,1995：130.
[14]Worth C. Worth's Squint. Its Causes, Pathology and Treatment, ed 6. London:Baillie're, Tindall & Cox,1929:55-61.
[15]卢炜,王京辉.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.
[16]孟详成.间歇性外斜视的成因、分类及手术选择[J].实用眼科杂志,1998,6(8)：458.
[17]赵玉琴,廉昌录.30例间歇性外斜视手术临床分析[J].中国斜视与小儿眼科杂志,2000,8(2)：116-119.
[18]李济华,初宪华,赵军,朱霈,田玉民.间歇性外斜视手术前后多因素转归的临床研究[J].山东大学基础医学院学报,2003,17(1)：55-60.
[19]栾瑛,王淑霞.共同性斜视眼外肌病理改变的研究[J].国际眼科杂志,2008,8(1)：94-96.
[20]左绪宏,王勇,牟鹏辉,王首雁,刘桂香.共同性外斜视内直肌纤维超微结构观察[J].眼科新进展,2008,28(10)：743-746.
[21]刘桂香,左绪宏.共同性外斜视内直肌胶原纤维超微结构观察[J].Chinese OPhthalmic Research,2007,25 (11):878-881.
[22]孙恒,李宪武,杜红,郭立云,孙卫锋.间歇性外斜视病人与正常人眼外肌肌酶组织化学染色的比较[J].中国斜视与小儿眼科杂志,2007,15(2)：49-53.
[23]Kim SH, Cho YA, Park CH, Uhm CS.The ultrastructural changes of tendon axonal profiles of medial rectus muscles according to duration in patients with intermittent exotropia [J]. Eye (Lond),2008,22(8):1076-1081.
[24]Robaei D, Rose KA, Kifley A, Cosstick M, IP JM, Mitchell P. Factors associated with childhood strabismus:findings from a population-based study [J]. Ophthalmology,2006,113(7):1146-1153.
[25]陈静,陈霞.间歇性外斜视患者屈光参差的特点及其对视功能的影响[J].中国实用眼科杂志,2008,26(11)：1211-1214.
[26]Stanila A, Mihai E, Saceleanu A, popa D, Santea M.Refractive changes in concomitant exodeviations[J].Ophtalmologia,2003,58(3):76-79.
[27]Burian HM, SPivey BE. The surgical management of exodeviations [J]. Am J Ophthalmol,1965,59(4):603-620.
[28]Kushner BJ. ExotroPic deviations:A functional classification and approach to treatment [J]. Am Ortho J,1988,38:81-93.
[29]赵堪兴,杨培增.眼科学[M].第七版,北京：人民卫生出版社,2008：259-260.
[30]Rutstein RP, Corliss DA.The clinical course of intermittent exotropia [J].Optom Vis Sci,2003,80(9):644-649.
[31]von Noorden, GK. Binocular vision and ocular motility:theory and management of strabismus [M].6th ed. St. Louis, Mosby.Inc,2002:356-372.
[32]Song SJ, Kim MM. The photophobia incidence, stereopsis and suppression in intermittent exotropia [J]. J Korean Ophthalmol Soc,2000,41:2254-2257.
[33]Lew H, Kim CH, Yun YS, Han SH.Binocular photophobia after surgical treatment in intermittent exotropia [J]. Optom Vis Sci,2007,84(12):1101-1103.
[34]杨景存.眼外肌病学[M].郑州：郑州大学出版社,2003：113-114.
[35]郝雨时.斜视[M].第一版,天津：科学技术出版社,1982：14-124,137-141.
[36]吴奇志,吴晓,卢炜,王京辉.间歇性外斜视手术前后双眼视觉的临床研究[J].中华眼科杂志,2007,439(11)：968-971.
[37]胡聪,黄欣,刘桂香,李慧,杨先,韩兵.正常和间歇性外斜视儿童立体视的研究[J].中华眼科杂志,2002,38(8)：452-456.
[38]Yildirim C, Altinsoy HI.Distance alternate-letter suppression test for objective assessment of sensorial status in intermittent exotropia [J]. Eur J Ophthalmol, 2000,10(1):4-10.
[39]Sharma P, Saxena R, Narvekar M, Gadia R, Menon V. Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia [J].Indian J Ophthalmol,2008,56(2):121-125.
[40]Hatt SR, Mohney BG, Leske DA, Holmes JM.Variability of stereoacuity in intermittent exotropia[J].Am J Ophthalmol,2008,145(3):556-561.
[41]卢炜,王京辉.间歇性外斜视患者交叉视差和非交叉视差的临床观察[J].中华眼科杂志,2002,38(8)：462-465.
[42]林楠,卢炜,王京辉.间歇性外斜视手术前后交叉视差和非交叉视差立体视觉的临床研究[J].中华眼科杂志,2006,42(2)：139-144.
[43]李月平,马惠芝.间歇性外斜视不同视差立体视的临床观察[J].中国实用眼科杂志,2009,27(1)：75-77.
[44]Mohney BG, Holmes JM.An office-based scale for assessing control in intermittent exotropia [J].Strabismus.2006,14(3):147-150.
[45]Haggerty H, Richardson S, Hrisos S, Strong NP, Clarke MP.The Newcastle Control Score:a new method of grading the severity of intermittent distance exotropia [J].Br J Ophthalmol,2004,88(2):233-235.
[46]American Academy of Ophthalmology.Basic and clinical science course, pediatric Ophthalmology and Strabismus [M].Section6,2004-2005,107.
[47]Arnoldi KA, Reynolds JD.Assessment of amplitude and control of the distance deviation in intermittent exotropia [J]. J Pediatr Ophthalmol Strabismus.2008, 45(3):150-153;
[48]Stathacopoulos RA, Rosenbaum AL, Zanoni D, Stager DR, McCall LC, Ziffer AJ, Everett M.Distance stereoacuity. Assessing control in intermittent exotropia [J]. Ophthalmology.1993,100(4):495-500.
[49]Hatt SR, Mohney BG, Leske DA, Holmes JM. Variability of control in intermittent exotropia [J].Ophthalmology,2008,115(2):371-376.
[50]Gurlu VP, Erda N.Diagnostic occlusion test in intermittent exotropia [J].J AAPOS,2008,12(5):504-506.
[51]Kushner BJ.The distance angle to target in surgery for intermittent exotropia [J].Arch Ophthalmol,1998,116(2):189-194.
[52]Hutchinson AK.Intermittent exotropia [J]. Ophthalmol Clin North Am,2001, 14(3):399-406.
[53]Caltrider N, Jampolsky A. Overcorrecting minus lens therapy for treatment of intermittent exotropia [J]. Ophthalmology,1983,90(10):1160-1165.
[54]Watts P, Tippings E, Al-Madfai H. Intermittent exotropia, overcorrecting minus lenses, and the Newcastle scoring system[J].J AAPOS,2005,9(5):460-464.
[55]Rowe FJ, Noonan CP, Freeman G, DeBell.J.Intervention for intermittent distance exotropia with overcorrecting minus lenses [J]. Eye (Lond),2009, 23(2):320-325.
[56]Freeman RS, Isenberg SJ. The use of part-time occlusion for early onset unilateral exotropia [J]. J Pediatr Ophthalmol Strabismus.1989,26(2):94-96.
[57]Suh YW, Kim SH, Lee JY, Cho YA. Conversion of intermittent exotropia types subsequent to part-time occlusion therapy and its sustainability [J]. Graefes Arch Clin Exp Ophthalmol,2006,244(6):705-708.
[58]Scheiman M, Mitchell GL, Cotter S, Cooper J, Kulp M, Rouse M, Borsting E, London R, Wensveen J, Convergence Insufficiency Treatment Trial Study Group. A randomized clinical trial of treatments for convergence insufficiency in children [J]. Arch OPhthalmol,2005,123(1):14-24.
[59]Scheiman M, Mitchell GL, Cotter S, Kulp MT, CooPer J, Rouse M, Borsting E, London R, Wensveen J.A randomized clinical trial of vision therapy/orthoptics versus pencil pushups for the treatment of convergence insufficiency in young adults[J]. Optom Vis Sci,2005,82(7):583-595.
[60]Garriott RS, Heyman CL, Rouse MW.Role of optometric vision therapy for surgically treated strabismus patients [J]. Optom Vis Sci,1997,74(4):179-184.
[61]Spencer RF, Tucker MG, Choi RY, McNeer KW.Botulinum toxin management of childhood intermittent exotropia [J]. Ophthalmology.1997,104(11): 1762-1767.
[62]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观察[J].眼科,2008,17(2)：115-117
[63]王戈平,苏玲.儿童间歇性外斜视手术后单眼注视综合征[J].中国斜视与小儿眼科杂志,2006,14(3)：180-182.
[64]Baker JD, Davies GT. Monofixational intermittent exotropia [J].Arch Ophthalmol.1979,97(1):93-95.
[65]Kushner BJ. The occurrence of monofixational exotropia after exotropia surgery [J].Am J Ophthalmol,2009,147(6):1082-1085.
[66]Pratt-Johnson JA, Barlow JM, Tillson G. Early surgery in intermittent exotropia [J]. Am J Ophthalmol,1977,84(5):689-694.
[67]Richard JM, Parks MM.Intermittent exotropia. Surgical results in different age groups [J]. Ophthalmology,1983,90(10):1172-1177.
[68]Asjes-Tydeman WL, Groenewoud H, van der Wilt GJ.Timing of surgery for primary exotropia in children.Strabismus [J].2006,14(4):191-197.
[69]Lee SY, Kim JH, Thacker NM.Augmented bilateral lateral rectus recession in basic intermittent exotropia [J]. J AAPOS,2007,11(3):266-268.
[70]Kushner BJ.Selective surgery for intermittent exotropia based on distance/near differences [J]. Arch Ophthalmol,1998,116(3):324-328.
[71]Chia A, Seenyen L, Long QB.Surgical experiences with two-muscle surgery for the treatment of intermittent exotropia[J]. J AAPOS,2006,10(3):206-211.
[72]Jeoung JW, Lee MJ, Hwang JM.Bilateral lateral rectus recession versus unilateral recess-resect procedure for exotropia with a dominant eye [J]. Am J Ophthalmol,2006,141(4):683-688.
[73]Maruo T, Kubota N, Sakaue T, Usui C.Intermittent exotropia surgery in children: long term outcome regarding changes in binocular alignment. A study of 666 cases [J]. Binocul Vis Strabismus Q,2001,16(4):265-270.
[74]Ekdawi NS, Nusz KJ, Diehl NN, Mohney BG.Postoperative outcomes in children with intermittent exotropia from a population-based cohort [J]. J AAPOS,2009,13(1):4-7.
[75]Christiansen SP, Harral RL 3rd, Brown H.Extraocular muscle fiber morphometry following combined recession-resection procedures in rabbits [J]. J Pediatr Ophthalmol Strabismus,1996,33 (5):247-250.
[76]Park SC, Kim YT, Kim SA, Oh SY. Changes in muscle fiber size and in the composition of myosin heavy chain isoforms of rabbit extraocular rectus muscle following recession surgery [J]. JPn J Ophthalmol,2008,52(5):386-392.
[77]Olitsky SE.Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia [J]. J Pediatr Ophthalmol Strabismus, 1998,35(3):146-148.
[78]Kim SH.Choi YJ.Effects of unilateral lateral rectus recession according to the tendon width in intermittent exotropia [J]. Eye (Lond),2006,20(7):785-788.
[79]Lee H, Kim SH.Bilateral lateral rectus recession considering the tendon width in intermittent exotropia [J]. Eye (Lond),2009,23(9):1808-1811.
[80]Choi MY, Hyung SM, Hwang JM.Unilateral recession-resection in children with exotropia of the convergence insufficiency type [J]. Eye (Lond),2007,21(3): 344-347.
[81]Choi MY, Hwang JM.The long-term result of slanted medial rectus resection in exotropia of the convergence insufficiency type [J]. Eye (Lond),2006,20(11): 1279-1283.
[82]Olitsky SE.Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia [J]. J Pediatr Ophthalmol Strabismus, 1998,35:146-148.
[83]Adams WE, Leske DA, Hatt SR, Mohney BG, Birch EE, Weakley DR Jr, Holmes JM.Improvement in distance stereoacuity following surgery for intermittent exotropia [J]. J AAPOS,2008,12(2):141-144.
[2]Pratt-Johnson JA, Barlow JM. Tillson G.Early surgery in intermittent exotropia [J].Am J Ophthalmol,1977,84(5):689-694.
[3]Asjes-Tydeman WL, Groenewoud H, van der Wilt GJ.Timing of surgery for primary exotropia in children [J]. Strabismus,2006,14(4):191-197.
[4]李济华,张玉环,韩振俊.间歇性外斜视手术治疗的临床观察[J].山东医大基础医学院学报,2000,14(5)：288-289.
[5]Yang CQ, Shen Y, Gu YS, Han W.Clinical investigation of surgery for intermittent exotropia [J]. J Zhejiang Univ Sci B,2008,9(6):470-473.
[6]Richard JM, Parks MM. Intermittent exotropia. Surgical results in different age groups [J].Ophthalmology,1983 (90):1172-1177.
[7]Ekdawi NS, Nusz KJ, Diehl NN, Mohney BG.Postoperative outcomes in children with intermittent exotropia from a population-based cohort[J].J AAPOS, 2009,13(1):4-7.
[8]数字化立体视觉检查图[M],颜少明,北京：人民卫出版社,2006,14-16.
[9]Julesz B.Binocular depth perception without familiarity cues [J].Science,1964,145(7)：356-362.
[10]Read J. Early computational processing in binocular vision and depth perception [J].Prog Biophys Mol Biol,2005,87(1):77-108.
[11]Nusz KJ, Mohney BG, Diehl NN.The Course of Intermittent Exotropia in a population-Based Cohort Ophthalmology [J].2006,113(7):1154-1158.
[12]von Noorden, GK. Binocular vision and ocular motility:theory and management of strabismus [M],6th ed. St. Louis, Mosby.Inc,2002:356-372.
[13]Leske DA, Holmes JM. Maximum Angle of Horizontal Strabismus Consistent with True Stereopsis [J].J AAPOS 2004(8):28-34.
[14]Holmes JM, Leske DA.Monocular clues in tests of stereoacuity [A]. In:Pritchard C. Transactions IX International Orthoptic Congress[C]. Nurnberg, Germany: Berufsverband der Orthoptistinnen Deutchlands Ev,1999:103-106.
[15]Simons K, Elhatton K.Artifacts in fusion and stereopsis testing based on red/green dichoptic image separation [J]. J Pediatr Ophthalmol Strabismus, 1994,31(5):290-297.
[16]Cornforth LL, Johnson BL, Kohl P, Roth N. Chromatic imbalance due to commonly used red-green filters reduces accuracy of stereoscopic depth perception [J]. Am J Optom Physiol Opt,1987,64(11):842-845.
[17]Wilcox LM, Robert F. Hess RF. When stereopsis does not improve with increasing contrast [J]. Vision Research,1998 (38):3671-3679.
[18]Jimenez JR,Rubino M, et al.Influence of the luminance signal and red-green and yellow-blue opponent chromatic signals in figural-stimuli stereograms [J]. Optom Vis Sci,1995,72(9):649-655.
[19]Osuobeni EP. Effect of chromatic aberration on isoluminance stereothreshold [J]. Optom Vis Sci,1991,68(7):552-555.
[20]Frisby JP,Davis H.Frisby Davis Distance Stereotest,Test Design & Test Instructions,Edition 4,2007,20.
[21]Holmes JM, Fawcett SL. Testing distance stereoacuity with the Frisby-Davis 2 (FD2) test [J]. Am J Ophthalmol,2005,139(1):193-195.
[22]Adams WE, Hrisos S, Richardson S, Davis H, Frisby JP, Clarke MP. Frisby Davis distance stereoacuity values in visually normal children [J]. Br J Ophthalmol,2005,89(11):1438-1441.
[23]Hong SW, Park SC. Development of distant stereoacuity in visually normal children as measured by the Frisby-Davis distance stereotest [J].Br J Ophthalmol, 2008,92(9):1186-1189.
[24]Holmes JM, Birch EE, Leske DA, Fu VL.Mohney BGNew tests of distance stereoacuity and their role in evaluating intermittent exotropia [J].Ophthalmology, 2007,114(6):1215-1220.
[25]Leske DA, Birch EE, Holmes JM. Real depth vs randot stereotests [J]. Am J Ophthalmol,2006,142(4):699-701.
[26]Fawcett SL. An evaluation of the agreement between contour-based circles and random dot-based near stereoacuity tests [J]. J AAPOS,2005,9(6):572-578.
[27]Rose D, Price E. Functional separation of global and local stereopsis investigated by cross-adaptation [J]. Neuro Psychologia,1995,33(3):269-274.
[28]Wang J, Hatt SR,O'Connor AR, Drover JR, Adams R, Birch EE, Holmes JM. Final version of the Distance Randot Stereotest:normative data,reliability,and validity[J]. J AAPOS,2010,14(2):142-146.
[29]胡聪,黄欣,刘桂香,李慧,杨先,韩兵.正常和间歇性外斜视儿童立体视的研究[J].中华眼科杂志,2002,38(8)：452-456.
[30]王霁雪,宋跃,杨隆艳.间歇性外斜视患者远距离立体视的临床特点[J].眼视光学杂,2005,7(3)：157-161.
[31]吴奇志,吴晓,卢炜,王京辉.间歇性外斜视手术前后双眼视觉的临床研究[J].中华眼科杂志2007,43(11)：968-971.
[32]Adams WE, Leske DA, Hatt SR, Mohney BG, Birch EE, Weakley DR, Holmes JM.Improvement in distance stereoacuity following surgery for intermittent exotropia[J].J AAPOS,2008,12(2):141-144.
[33]Sharma P, Saxena R, Narvekar M, Gadia R, Menon V. Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia. Indian J Ophthalmol,2008,56(2):121-125.
[34]卢炜,王京辉.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—290.
[35]刘垠,戴鸿斌,宋天勤.远立体视测定对间歇性外斜视手术时机选择的临床观察[J].中国斜视与小儿眼科杂志,2000,8(4)：152-154.
[36]Fawcett SL, Stager DR Sr, Felius J.Factors influencing stereoacuity outcomes in adults with acquired strabismus [J]. Am J Ophthalmol,2004,138(6):931-935.
[37]中华眼科学会全国儿童弱视斜视防治学组.中国斜视与小儿眼科杂志,1996,4(4)：145.
[38]卢炜,王京辉,李林.间歇性外斜视手术欠矫与过矫对立体视锐度影响的临床观察[J].中国斜视与小儿眼科杂志,2007,15(3)：103-105.
[39]郭静秋,臧英芬,甘晓玲.儿童立体视的成熟期及几种检查法的比较[J].北京医科大学学报,1993,25(1)：24-26.
[40]李少敏,甘晓玲,郭静秋.立体视锐度的临床检查及评价中国斜视与小儿眼科杂志[J].1994,26(4)：156-159.
[41]Romano PE, Romano JA, Puklin JE. Stereoacuity development in children with normal binocular single vision [J]. Am J Ophthalmol,1975,79(6):966-971.
[42]张伟赵堪兴.间歇性外斜视手术前后的立体视功能及手术时机探讨[J].眼科新进展,2002,22(5)：337-338.
[43]Yildirim C, Mutlu FM, Chen Y, Altinsoy HI.Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery [J].. Am J Ophthalmol,1999,128(2): 222-230.
[44]Mohney BG, Holmes JM. An office-based scale for assessing control in intermittent exotropia [J]. Strabismus,2006(3),14:147-150.
[45]American Academy of Ophthalmology.Basic and clinical science course, pediatric Ophthalmology and Strabismus [M].Section6,2004-2005,107.
[46]Arnoldi KA,Reynolds JD.Assessment of amplitude and control of the distance deviation in intermittent exotropia[J]. J Pediatr Ophthalmol Strabismus,2008, 45(3):150-153.
[47]Haggerty H, Richardson S, Hrisos S, Strong NP, Clarke MP.The Newcastle control score:a new method of grading the severity of intermittent distance exotropia [J]. Br J Ophthalmol 2004,88(2):233-235.
[48]Stathacopoulos RA, Rosenbaum AL, Zanoni D, Stager DR, McCall LC, Ziffer AJ, Everett M. Distance stereoacuity. Assessing control in intermittent exotropia [J]. Ophthalmology,1993,100(4):495-500.
[49]Buck D, Clarke MP, Haggerty H, Hrisos S,Powell C, Sloper J, Strong NP.Grading the severity of intermittent distance exotropia:the revised Newcastle Control Score [J]. Br J Ophthalmol,2008,92(4):577.
[50]Cumming BG. An unexpected specialization for horizontal disparity in primate primary visual cortex [J]. Nature,2002,418(6898):633-636.
[1]Friedman DS, Repka MX, Katz J, Giordano L, Ibironke J, Hawse P, Tielsch JM. Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study [J].Ophthalmology,2009,116(11):2128-2134.
[2]Govindan M, Mohney BG, Diehl NN, Burke JP.Incidence and types of childhood exotropia:a population-based study [J]. Ophthalmology,2005,112(1):104-108.
[3]Chia A, Seenyen L, Long QB.A retrospective review of 287 consecutive children in singapore presenting with intermittent exotropia[J].J AAPOS, 2005,9(3):257-263.
[4]Yu CB, Fan DS, Wong VW, Wong CY, Lam DS. Changing patterns of strabismus: a decade of experience in Hong Kong [J]. Br J Ophthalmol,2002,86(8):854-856.
[5]王京辉,卢炜.共同性外斜视各类型分布的临床观察[J].眼科,2006,15(5)：331-334.
[6]Mohney BG.Common forms of childhood strabismus in an incidence cohort [J]. Am J Ophthalmol,2007,144(3):465-467.
[7]杨美琼,黄灵聪.厦门市8421名4～6岁儿童眼病调查[J].中国儿童保健杂志,2005,13(2)：171.
[8]Jenkins R. Demograhics:geographic variations in the prevalence and management of exotropia [J]. Am Orthopt J,1992(42):82.
[9]李凤鸣.中华眼科学[M].第二版北京：人民卫生出版社,2005：2725-2730.
[10]Nusz KJ, Mohney BG, Diehl NN.Female predominance in intermittent exotropia [J].Am J Ophthalmol,2005,140(3):546-547.
[11]Nusz KJ, Mohney BG, Diehl NN. The course of intermittent exotropia in a population-based cohort [J]. Ophthalmology,2006,113(7):1154-1158.
[12]von Noorden, GK. Binocular vision and ocular motility:theory and management of strabismus [M],6th ed. St. Louis, Mosby.Inc,2002,134-152.
[13]牛兰俊.斜视新概念[M].北京：北京医科大学、中国协和医科大学联合出版社,1995：130.
[14]Worth C. Worth's Squint. Its Causes, Pathology and Treatment, ed 6. London:Baillie're, Tindall & Cox,1929:55-61.
[15]卢炜,王京辉.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.
[16]孟详成.间歇性外斜视的成因、分类及手术选择[J].实用眼科杂志,1998,6(8)：458.
[17]赵玉琴,廉昌录.30例间歇性外斜视手术临床分析[J].中国斜视与小儿眼科杂志,2000,8(2)：116-119.
[18]李济华,初宪华,赵军,朱霈,田玉民.间歇性外斜视手术前后多因素转归的临床研究[J].山东大学基础医学院学报,2003,17(1)：55-60.
[19]栾瑛,王淑霞.共同性斜视眼外肌病理改变的研究[J].国际眼科杂志,2008,8(1)：94-96.
[20]左绪宏,王勇,牟鹏辉,王首雁,刘桂香.共同性外斜视内直肌纤维超微结构观察[J].眼科新进展,2008,28(10)：743-746.
[21]刘桂香,左绪宏.共同性外斜视内直肌胶原纤维超微结构观察[J].Chinese OPhthalmic Research,2007,25 (11):878-881.
[22]孙恒,李宪武,杜红,郭立云,孙卫锋.间歇性外斜视病人与正常人眼外肌肌酶组织化学染色的比较[J].中国斜视与小儿眼科杂志,2007,15(2)：49-53.
[23]Kim SH, Cho YA, Park CH, Uhm CS.The ultrastructural changes of tendon axonal profiles of medial rectus muscles according to duration in patients with intermittent exotropia [J]. Eye (Lond),2008,22(8):1076-1081.
[24]Robaei D, Rose KA, Kifley A, Cosstick M, IP JM, Mitchell P. Factors associated with childhood strabismus:findings from a population-based study [J]. Ophthalmology,2006,113(7):1146-1153.
[25]陈静,陈霞.间歇性外斜视患者屈光参差的特点及其对视功能的影响[J].中国实用眼科杂志,2008,26(11)：1211-1214.
[26]Stanila A, Mihai E, Saceleanu A, popa D, Santea M.Refractive changes in concomitant exodeviations[J].Ophtalmologia,2003,58(3):76-79.
[27]Burian HM, SPivey BE. The surgical management of exodeviations [J]. Am J Ophthalmol,1965,59(4):603-620.
[28]Kushner BJ. ExotroPic deviations:A functional classification and approach to treatment [J]. Am Ortho J,1988,38:81-93.
[29]赵堪兴,杨培增.眼科学[M].第七版,北京：人民卫生出版社,2008：259-260.
[30]Rutstein RP, Corliss DA.The clinical course of intermittent exotropia [J].Optom Vis Sci,2003,80(9):644-649.
[31]von Noorden, GK. Binocular vision and ocular motility:theory and management of strabismus [M].6th ed. St. Louis, Mosby.Inc,2002:356-372.
[32]Song SJ, Kim MM. The photophobia incidence, stereopsis and suppression in intermittent exotropia [J]. J Korean Ophthalmol Soc,2000,41:2254-2257.
[33]Lew H, Kim CH, Yun YS, Han SH.Binocular photophobia after surgical treatment in intermittent exotropia [J]. Optom Vis Sci,2007,84(12):1101-1103.
[34]杨景存.眼外肌病学[M].郑州：郑州大学出版社,2003：113-114.
[35]郝雨时.斜视[M].第一版,天津：科学技术出版社,1982：14-124,137-141.
[36]吴奇志,吴晓,卢炜,王京辉.间歇性外斜视手术前后双眼视觉的临床研究[J].中华眼科杂志,2007,439(11)：968-971.
[37]胡聪,黄欣,刘桂香,李慧,杨先,韩兵.正常和间歇性外斜视儿童立体视的研究[J].中华眼科杂志,2002,38(8)：452-456.
[38]Yildirim C, Altinsoy HI.Distance alternate-letter suppression test for objective assessment of sensorial status in intermittent exotropia [J]. Eur J Ophthalmol, 2000,10(1):4-10.
[39]Sharma P, Saxena R, Narvekar M, Gadia R, Menon V. Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia [J].Indian J Ophthalmol,2008,56(2):121-125.
[40]Hatt SR, Mohney BG, Leske DA, Holmes JM.Variability of stereoacuity in intermittent exotropia[J].Am J Ophthalmol,2008,145(3):556-561.
[41]卢炜,王京辉.间歇性外斜视患者交叉视差和非交叉视差的临床观察[J].中华眼科杂志,2002,38(8)：462-465.
[42]林楠,卢炜,王京辉.间歇性外斜视手术前后交叉视差和非交叉视差立体视觉的临床研究[J].中华眼科杂志,2006,42(2)：139-144.
[43]李月平,马惠芝.间歇性外斜视不同视差立体视的临床观察[J].中国实用眼科杂志,2009,27(1)：75-77.
[44]Mohney BG, Holmes JM.An office-based scale for assessing control in intermittent exotropia [J].Strabismus.2006,14(3):147-150.
[45]Haggerty H, Richardson S, Hrisos S, Strong NP, Clarke MP.The Newcastle Control Score:a new method of grading the severity of intermittent distance exotropia [J].Br J Ophthalmol,2004,88(2):233-235.
[46]American Academy of Ophthalmology.Basic and clinical science course, pediatric Ophthalmology and Strabismus [M].Section6,2004-2005,107.
[47]Arnoldi KA, Reynolds JD.Assessment of amplitude and control of the distance deviation in intermittent exotropia [J]. J Pediatr Ophthalmol Strabismus.2008, 45(3):150-153;
[48]Stathacopoulos RA, Rosenbaum AL, Zanoni D, Stager DR, McCall LC, Ziffer AJ, Everett M.Distance stereoacuity. Assessing control in intermittent exotropia [J]. Ophthalmology.1993,100(4):495-500.
[49]Hatt SR, Mohney BG, Leske DA, Holmes JM. Variability of control in intermittent exotropia [J].Ophthalmology,2008,115(2):371-376.
[50]Gurlu VP, Erda N.Diagnostic occlusion test in intermittent exotropia [J].J AAPOS,2008,12(5):504-506.
[51]Kushner BJ.The distance angle to target in surgery for intermittent exotropia [J].Arch Ophthalmol,1998,116(2):189-194.
[52]Hutchinson AK.Intermittent exotropia [J]. Ophthalmol Clin North Am,2001, 14(3):399-406.
[53]Caltrider N, Jampolsky A. Overcorrecting minus lens therapy for treatment of intermittent exotropia [J]. Ophthalmology,1983,90(10):1160-1165.
[54]Watts P, Tippings E, Al-Madfai H. Intermittent exotropia, overcorrecting minus lenses, and the Newcastle scoring system[J].J AAPOS,2005,9(5):460-464.
[55]Rowe FJ, Noonan CP, Freeman G, DeBell.J.Intervention for intermittent distance exotropia with overcorrecting minus lenses [J]. Eye (Lond),2009, 23(2):320-325.
[56]Freeman RS, Isenberg SJ. The use of part-time occlusion for early onset unilateral exotropia [J]. J Pediatr Ophthalmol Strabismus.1989,26(2):94-96.
[57]Suh YW, Kim SH, Lee JY, Cho YA. Conversion of intermittent exotropia types subsequent to part-time occlusion therapy and its sustainability [J]. Graefes Arch Clin Exp Ophthalmol,2006,244(6):705-708.
[58]Scheiman M, Mitchell GL, Cotter S, Cooper J, Kulp M, Rouse M, Borsting E, London R, Wensveen J, Convergence Insufficiency Treatment Trial Study Group. A randomized clinical trial of treatments for convergence insufficiency in children [J]. Arch OPhthalmol,2005,123(1):14-24.
[59]Scheiman M, Mitchell GL, Cotter S, Kulp MT, CooPer J, Rouse M, Borsting E, London R, Wensveen J.A randomized clinical trial of vision therapy/orthoptics versus pencil pushups for the treatment of convergence insufficiency in young adults[J]. Optom Vis Sci,2005,82(7):583-595.
[60]Garriott RS, Heyman CL, Rouse MW.Role of optometric vision therapy for surgically treated strabismus patients [J]. Optom Vis Sci,1997,74(4):179-184.
[61]Spencer RF, Tucker MG, Choi RY, McNeer KW.Botulinum toxin management of childhood intermittent exotropia [J]. Ophthalmology.1997,104(11): 1762-1767.
[62]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观察[J].眼科,2008,17(2)：115-117
[63]王戈平,苏玲.儿童间歇性外斜视手术后单眼注视综合征[J].中国斜视与小儿眼科杂志,2006,14(3)：180-182.
[64]Baker JD, Davies GT. Monofixational intermittent exotropia [J].Arch Ophthalmol.1979,97(1):93-95.
[65]Kushner BJ. The occurrence of monofixational exotropia after exotropia surgery [J].Am J Ophthalmol,2009,147(6):1082-1085.
[66]Pratt-Johnson JA, Barlow JM, Tillson G. Early surgery in intermittent exotropia [J]. Am J Ophthalmol,1977,84(5):689-694.
[67]Richard JM, Parks MM.Intermittent exotropia. Surgical results in different age groups [J]. Ophthalmology,1983,90(10):1172-1177.
[68]Asjes-Tydeman WL, Groenewoud H, van der Wilt GJ.Timing of surgery for primary exotropia in children.Strabismus [J].2006,14(4):191-197.
[69]Lee SY, Kim JH, Thacker NM.Augmented bilateral lateral rectus recession in basic intermittent exotropia [J]. J AAPOS,2007,11(3):266-268.
[70]Kushner BJ.Selective surgery for intermittent exotropia based on distance/near differences [J]. Arch Ophthalmol,1998,116(3):324-328.
[71]Chia A, Seenyen L, Long QB.Surgical experiences with two-muscle surgery for the treatment of intermittent exotropia[J]. J AAPOS,2006,10(3):206-211.
[72]Jeoung JW, Lee MJ, Hwang JM.Bilateral lateral rectus recession versus unilateral recess-resect procedure for exotropia with a dominant eye [J]. Am J Ophthalmol,2006,141(4):683-688.
[73]Maruo T, Kubota N, Sakaue T, Usui C.Intermittent exotropia surgery in children: long term outcome regarding changes in binocular alignment. A study of 666 cases [J]. Binocul Vis Strabismus Q,2001,16(4):265-270.
[74]Ekdawi NS, Nusz KJ, Diehl NN, Mohney BG.Postoperative outcomes in children with intermittent exotropia from a population-based cohort [J]. J AAPOS,2009,13(1):4-7.
[75]Christiansen SP, Harral RL 3rd, Brown H.Extraocular muscle fiber morphometry following combined recession-resection procedures in rabbits [J]. J Pediatr Ophthalmol Strabismus,1996,33 (5):247-250.
[76]Park SC, Kim YT, Kim SA, Oh SY. Changes in muscle fiber size and in the composition of myosin heavy chain isoforms of rabbit extraocular rectus muscle following recession surgery [J]. JPn J Ophthalmol,2008,52(5):386-392.
[77]Olitsky SE.Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia [J]. J Pediatr Ophthalmol Strabismus, 1998,35(3):146-148.
[78]Kim SH.Choi YJ.Effects of unilateral lateral rectus recession according to the tendon width in intermittent exotropia [J]. Eye (Lond),2006,20(7):785-788.
[79]Lee H, Kim SH.Bilateral lateral rectus recession considering the tendon width in intermittent exotropia [J]. Eye (Lond),2009,23(9):1808-1811.
[80]Choi MY, Hyung SM, Hwang JM.Unilateral recession-resection in children with exotropia of the convergence insufficiency type [J]. Eye (Lond),2007,21(3): 344-347.
[81]Choi MY, Hwang JM.The long-term result of slanted medial rectus resection in exotropia of the convergence insufficiency type [J]. Eye (Lond),2006,20(11): 1279-1283.
[82]Olitsky SE.Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia [J]. J Pediatr Ophthalmol Strabismus, 1998,35:146-148.
[83]Adams WE, Leske DA, Hatt SR, Mohney BG, Birch EE, Weakley DR Jr, Holmes JM.Improvement in distance stereoacuity following surgery for intermittent exotropia [J]. J AAPOS,2008,12(2):141-144.