先天性内斜视手术结果。

Results of surgery for congenital esotropia.

机构信息

Ramón Pando Ferrer Ophthalmology Institute, Havana, Cuba.

出版信息

MEDICC Rev. 2011 Jan;13(1):18-22. doi: 10.37757/MR2011V13.N1.6.

DOI:10.37757/MR2011V13.N1.6

PMID:21351685

Abstract

INTRODUCTION

Congenital esotropia is a convergent deviation of the eyes when fixating on an object. It appears during the first six months of life and affects muscle structure and physiology, as well as the relation of the eyes with the environment, retinal relations and neural integration phenomena. Amblyopia develops in 30-50% of those affected. Timely surgery is effective in most cases.

OBJECTIVE

Describe surgical results in congenital esotropia cases treated in the Pediatric Ophthalmology and Strabismus Service of the Ramon Pando Ferrer Ophthalmology Institute in Havana between January 2008 and May 2009.

METHODS

A descriptive, retrospective study was carried out through review of 127 cases (aged 1-18 years, 55 male and 72 female) operated on for congenital esotropia between January 2008 and May [corrected] 2009. Variables used were: age at surgery, degree of preoperative amblyopia, type of fixation, refractive error, associated conditions, type of surgery performed and pre- and postoperative deviation angles.

RESULTS

The largest number of congenital esotropia cases were found in children <2 years old (38.6%). Before surgery, 37% of cases studied showed mild amblyopia; 22.8% moderate and 12.6% severe; 27.6% did not cooperate with visual acuity testing. With respect to fixation: 91.3% showed central fixation and 8.7% eccentric. Refractive errors found were: mild hyperopia (65.4%), moderate hyperopia (29.1%), and myopia (5.5%). Associated conditions were: overaction of the inferior oblique muscles (48%), latent nystagmus (16.5%), and dissociated vertical deviation (8.7%); no alterations were found in 26.8% of cases. The most frequently used surgical treatment was bilateral medial rectus muscle recession (92.1%). The most common preoperative deviation angle range was 31–40 prism diopters (PD) in 51.9% of patients; the postoperative deviation angle most commonly found after 12 months was <10 PD in 64.6% (orthotropia).

CONCLUSIONS

Surgery, most commonly with medial rectus muscle resection, was effective in correcting congenital esotropia.

摘要

引言

先天性内斜视是一种眼睛注视物体时的会聚性偏斜。它在生命的头六个月出现，影响肌肉结构和生理学，以及眼睛与环境的关系、视网膜关系和神经整合现象。30-50%的受影响者会发展为弱视。及时手术在大多数情况下是有效的。

目的

描述 2008 年 1 月至 2009 年 5 月期间在哈瓦那 Ramon Pando Ferrer 眼科研究所小儿眼科和斜视服务处治疗的先天性内斜视病例的手术结果。

方法

通过回顾 2008 年 1 月至 2009 年 5 月期间因先天性内斜视接受手术的 127 例（年龄 1-18 岁，55 名男性和 72 名女性）的病例，进行描述性、回顾性研究。使用的变量包括：手术年龄、术前弱视程度、固视类型、屈光不正、合并症、手术类型以及术前和术后偏斜角度。

结果

年龄<2 岁的儿童中发现的先天性内斜视病例最多（38.6%）。术前，37%的研究病例表现为轻度弱视；22.8%为中度弱视，12.6%为重度弱视；27.6%不配合视力测试。固视方面：91.3%为中心固视，8.7%为偏心固视。发现的屈光不正为：轻度远视（65.4%）、中度远视（29.1%）和近视（5.5%）。合并症为：下斜肌亢进（48%）、隐性眼球震颤（16.5%）和分离性垂直偏斜（8.7%）；26.8%的病例未发现异常。最常使用的手术治疗是双侧内直肌后退（92.1%）。最常见的术前偏斜角度范围是 31-40 棱镜度（PD），占 51.9%的患者；术后 12 个月最常见的偏斜角度是<10 PD，占 64.6%（正位）。