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外斜视的单侧和双侧外直肌后徙术

Unilateral and bilateral lateral rectus recession in exotropia.

作者信息

Spierer Abraham, Ben-Simon Guy J

机构信息

Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

Ophthalmic Surg Lasers Imaging. 2005 Mar-Apr;36(2):114-7.

Abstract

BACKGROUND AND OBJECTIVE

To evaluate the surgical results obtained by unilateral and bilateral lateral rectus recession for the correction of exotropia.

PATIENTS AND METHODS

The charts of all patients with exotropia who were operated on at the Goldschleger Eye Institute at Sheba Medical Center during an 11-year period were retrospectively reviewed. Study participants all underwent a complete orthoptic and ocular examination. Twenty-five patients with moderate-angle exotropia underwent unilateral lateral rectus recession (group 1) and 38 patients with large-angle exotropia underwent bilateral lateral rectus recession (group 2). The angle of exotropia was measured by the prism and cover test. Moderate exotropia was defined as 25 prism diopters (PD) and large-angle exotropia as greater than 25 PD.

RESULTS

The mean age at the time of the surgery was 10.0+/-5.2 years in group 1 and 8.5+/-8.0 years in group 2. The mean preoperative exotropia was 16.1+/-5.7 PD in group 1 and 29.6+/-14.4 PD in group 2. A mean postoperative exodeviation of 4.2+/-5.4 PD was found in group 1 and 5.8+/-13.6 PD in group 2. The success rate (deviation of < 10 PD) was 84% in group 1 and 74% in group 2. There was no incomitance in group 1.

CONCLUSION

Unilateral lateral rectus recession is an effective surgical method for correcting moderate-angle exotropia with results similar to bilateral lateral rectus recession for larger exotropia angles.

摘要

背景与目的

评估单侧和双侧外直肌后徙术矫正外斜视的手术效果。

患者与方法

回顾性分析在11年期间于舍巴医疗中心的戈德施莱格尔眼科研究所接受手术的所有外斜视患者的病历。研究参与者均接受了全面的视光学和眼科检查。25例中度外斜视患者接受单侧外直肌后徙术(第1组),38例大角度外斜视患者接受双侧外直肌后徙术(第2组)。通过三棱镜加遮盖试验测量外斜视角度。中度外斜视定义为25三棱镜度(PD),大角度外斜视定义为大于25 PD。

结果

第1组手术时的平均年龄为10.0±5.2岁,第2组为8.5±8.0岁。第1组术前平均外斜视度数为16.1±5.7 PD,第2组为29.6±14.4 PD。第1组术后平均外斜视度数为4.2±5.4 PD,第2组为5.8±13.6 PD。第1组成功率(斜视度数<10 PD)为84%,第2组为74%。第1组无斜视度数不一致情况。

结论

单侧外直肌后徙术是矫正中度外斜视的有效手术方法,其效果与双侧外直肌后徙术矫正较大外斜视角度的效果相似。

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