Polling J-R, Eijkemans M J C, Esser J, Gilles U, Kolling G H, Schulz E, Lorenz B, Roggenkämper P, Herzau V, Zubcov A, ten Tusscher M P M, Wittebol-Post D, Gusek-Schneider G C, Cruysberg J R M, Simonsz H J
Department of Ophthalmology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
Br J Ophthalmol. 2009 Jul;93(7):954-7. doi: 10.1136/bjo.2008.149658. Epub 2009 Mar 30.
Infantile esotropia, a common form of strabismus, is treated either by bilateral recession (BR) or by unilateral recession-resection (RR). Differences in degree of alignment achieved by these two procedures have not previously been examined in a randomised controlled trial.
Controlled, randomised multicentre trial.
12 university clinics.
124 patients were randomly assigned to either BR or RR. Standardised protocol prescribed that the total relocation of the muscles, in millimetres, was calculated by dividing the preoperative latent angle of strabismus at distance, in degrees, by 1.6.
Alignment assessed as the variation of the postoperative angle of strabismus during alternating cover.
The mean preoperative latent angle of strabismus at distance fixation was +17.2 degrees (SD 4.4) for BR and +17.5 degrees (4.0) for RR. The mean postoperative angle of strabismus at distance was +2.3 degrees (5.1) for BR and +2.9 degrees (3.5) for RR (p = 0.46 for reduction in the angle and p = 0.22 for the within-group variation). The mean reduction in the angle of strabismus was 1.41 degrees (0.45) per millimetre of muscle relocation for RR and 1.47 (0.50) for BR (p = 0.50 for reduction in the angle). Alignment was associated with postoperative binocular vision (p = 0.001) in both groups.
No statistically significant difference was found between BR and RR as surgery for infantile esotropia.
婴儿型内斜视是斜视的一种常见形式，可通过双侧后徙术（BR）或单侧后徙-切除术（RR）进行治疗。此前尚未在随机对照试验中研究这两种手术在实现眼位矫正程度上的差异。
对照随机多中心试验。
12家大学诊所。
124例患者被随机分配至BR组或RR组。标准化方案规定，肌肉总移位量（以毫米为单位）通过将术前远距离斜视潜在角度（以度为单位）除以1.6来计算。
在交替遮盖试验中，将斜视术后角度的变化作为眼位矫正情况进行评估。
BR组术前远距离固定时斜视潜在角度的平均值为+17.2度（标准差4.度），RR组为+17.5度（4.0度）。BR组术后远距离斜视角度的平均值为+2.3度（5.1度），RR组为+2.9度（3.5度）（角度减小方面p = 0.46，组内差异方面p = 0.22）。RR组每毫米肌肉移位的斜视角度平均减小量为1.41度（0.45度），BR组为1.47度（0.50度）（角度减小方面p = 0.50）。两组中眼位矫正均与术后双眼视觉相关（p = 0.001）。
作为婴儿型内斜视的手术方式，BR和RR之间未发现具有统计学意义的差异。
