InternationalJournalofOphthalmology，V01．6，No．5，Oct．2006Tel：029—82245172EmaihIJO．2000@163．comwww．IJO．ca·Originalarticle·ClinicalcharacteristicsandsurgicalmanagementinA-patternexotropiaAbstract。AIM：T0surveythepathogenesis．clinicaIcharacterist：icsandsurgicaltreatmentforthecorrectionofA-patternex-otropia．。M日rHODS：ThecasehistoryandsurgicaleffeCtof62A—pat-ternexotropiain1825strabismuswerestudied．Thesuperiorobliquemusclesweakeningorthehorizontalmusclesproce-dureswereperformedinallpatientsaccordingtothedysfunc-tionofthesuperiorobliquemuscles，horizontaIdeviation，withorwithoutbinocularvision．Follow—uDaftersurgerywas6-18monthswithmeandurationof9months．。RESULTs：A-patternexotropiaaccountsfor3．4％ofalIstra-bismus．A-patternexotropiaaccountsfor21．2％ofA-Vsyn-drome．Aftersurgery，52oasesgotalignment，56oasesgainedA-signcorrectionand54casesrecoveredbinocularvision．。CONCLUSION：A-patternexotropiajsacommonlypeinstrabismus，itsetiologyismainlyobliquemuscledysfunction．Differentsurgicalproceduresshouldbeselectedaccordingtooveractiondegreesofobliquemuscleandbinocularvisionfunction，whk；hcanacquirethesatisfiedresults．■。KEYWORDS：A-patternexotropia；clinicalcharacteristits：surgicaltreatmentDongN，LiuLQ，LiPH．Clinicalcharacteristicsandsurgicalman—agementinA—patternexotropia．IntJOphthalmol(OuojiYankeZa—zh0，2006；6(5)：999-1001INTRoDUCTIoN，_T1heterms”A”pattemand”V”pattemdescribehorizontal上strabismusthatisverticallyincomitant．Itischaracter-izedbyasubstantialincreaseordecreaseinhorizontaldevia-tioninthemidlinepositioninupgazeascomparedtodowngaze．yonNoordentl]describedthatapproximately25％ofpatientswithstrabismushaveanassociated”A”or”V”paRern．Estimatesofthepercentageofpatientswithstrabis．musthathavean”A”or”V”pattemrangefrom15％to25％byScoR【2]．Duke．Elder[3】emphasizedthatthecorrectionof”A”or”V”pattemwasimportantwhentreatmentofthechil—dren’shorizontalstrabismusin1973．Becausethecorrectionof”A”or”V”paaemwilltakeadvantageofgeeingbinocularDepartmentofOphthalmology，WestChinaHospital，SichuanUni—versityChengdu61004l，SichuanProvince，ChinaCorresopondenceto：Long-QianLiu．DepartmentofOphthalmol—ogy，WestChinaHospital，SichuanUniversityChengdu610041，SichuanProvince，China．bql5651@hotmail．comReceived：2006．．07．．14Accepted：2006-．09．-13visionfunction．An”A”paRernischaracterizedbyeyesthataremoreconverged(moreesotropicorlessexotropic)inupgazeascomparedtodowngaze．A-pattemexotroplashowsadecreaseororthophoriainupgaze，however，anin．creaseintheexotropiaindowngaze．Inthisstudywede．scribetheclinicalcharacteristicsandsurgicalmanagementof62casesA．．patternexotropiaofdepartmentofophthalmolo．．gyofWestChinaHospitalofSichuanUniversity，China．MATERIALSANDMETHoDSPatientsThese62casesA．paRemexotropiawasobtainedfrom1825strabismusduringJanuary．1995toDecember．2003．Thesepatientsincluded32males。30females．withthemeanageof13．8(4-28)．Follow-upaftersurgerywas6—18monthswithmeandurationof9months．ExaminationMethodsDeterminationofangleofstrabismusBasedonprismpluscovertestingandsynoptophorequantitativelymeasuredtheanglesofdeviationofninediagnosticpositions．Thea11．glesofdeviationincludeduncorrectedandfullopticalcor．recteddeviationinametropia．TheA-pattemexotropiaweredemonstratedbymeasuringadeviationinprimarypositionandapproximately25...
