Wang Lihua, Nelson Leonard B
Department of Pediatric Ophthalmology and Strabismus, Wills Eye Institute, Philadelphia, PA 19107, USA.
J Pediatr Ophthalmol Strabismus. 2011 Jan-Feb;48(1):20-4. doi: 10.3928/01913913-20100818-05. Epub 2010 Aug 23.
To report an outcome study of 123 consecutive patients treated by graded unilateral medial rectus recession for small to moderate angle esotropia over an 8-year period with a minimum follow-up of 6 months.
The records of patients who underwent unilateral medial rectus recession for constant esotropia measuring 15 to 35 prism diopters (PD) were reviewed. Unilateral medial rectus recession of 5.0, 5.5, 6.0, 6.5, and 7.0 mm was performed for 15 to 18, 19 to 20, 21 to 25, 26 to 30, and 31 to 35 PD of esodeviation, respectively. Postoperative follow-up was at least 6 months. Successful alignment was defined as ±5 PD of orthophoria in primary and lateral gaze while viewing distant and near accommodative targets.
The eyes of 96.8% of the patients were successfully aligned and the average deviation corrected was 17.33 ± 1.16 PD for 5 mm, 18.57 ± 2.51 PD for 5.5 mm, 23.67 ± 4.91 PD for 6 mm, 26.68 ± 3.87 PD for 6.5 mm, and 31.93 ± 3.26 PD for 7 mm unilateral medial rectus recession at 6-month follow-up. Seventy-four patients (83.2%) with more than 6 months of follow-up achieved successful alignment, 14 (15.7%) were under-corrected, and 1 (1.1%) was overcorrected.
Successful alignment was achieved in most esotropic patients treated by the graded unilateral medial rectus recessions. The surgical guidelines provide a reference for the treatment of small to moderate angle esotropia.
报告一项对123例连续患者进行的疗效研究，这些患者在8年期间接受了分级单侧内直肌后徙术治疗轻至中度内斜视，随访时间至少为6个月。
回顾了因恒定内斜视接受单侧内直肌后徙术的患者记录，内斜视度数为15至35三棱镜度（PD）。分别对15至18、19至20、21至25、26至30和31至35 PD的内斜视进行5.0、5.5、6.0、6.5和7.0 mm的单侧内直肌后徙术。术后随访至少6个月。成功矫正定义为在注视远距离和近距离调节目标时，第一眼位和侧方注视位的眼位正位偏差在±5 PD以内。
96.8%的患者眼位成功矫正，6个月随访时，5 mm单侧内直肌后徙术平均矫正偏差为17.33±1.16 PD，5.5 mm为18.57±2.51 PD，6 mm为23.67±4.91 PD，6.5 mm为26.68±3.87 PD，7 mm为31.93±3.26 PD。74例（83.2%）随访时间超过6个月的患者眼位成功矫正，14例（15.7%）矫正不足，1例（1.1%）矫正过度。
大多数接受分级单侧内直肌后徙术治疗的内斜视患者实现了成功矫正。该手术指南为轻至中度内斜视的治疗提供了参考。
