Bae Hyoung Won, Chung Seung Ah, Yoon Jin Sook, Lee Jong Bok
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
J Pediatr Ophthalmol Strabismus. 2012 Jan-Feb;49(1):49-53. doi: 10.3928/01913913-20110517-01. Epub 2011 May 24.
To determine whether changes in ocular alignment following general anesthesia, as measured by interpupillary distance, can be used as a predictor for surgical outcomes in children with intermittent exotropia.
The authors obtained digital photographs of 40 children with exotropia and 20 children with epiblepharon (control group) before and immediately after induction of general anesthesia in the primary supine position. Differences in the anatomic interpupillary distance (aIPD) for each patient were measured and compared with the preoperative angles of deviation. They were also correlated with surgical outcomes on the first day and 1 year after surgery.
All 60 patients demonstrated an increase in aIPD following general anesthesia. The mean change in aIPD in patients with exotropia was similar to that in patients with epiblepharon (3.78% ± 2.53% and 3.15% ± 1.05%, respectively). In patients with exotropia, there was a significant positive linear correlation between the preoperative distance deviation (P) and the change in eye position (A): A = 0.362 P - 4.488, r(2) = 0.476 (P < .001). Five (71%) of seven patients whose changes were outside the 80% confidence interval for expected values had poor surgical outcomes on the first postoperative day and four had unsatisfactory results 1 year after surgery.
Changes in aIPD following general anesthesia were strongly correlated with preoperative angle of deviation. Therefore, they may be a useful predictor of surgical outcomes in children with exotropia.
确定通过瞳孔间距测量的全身麻醉后眼位的变化是否可作为间歇性外斜视患儿手术结果的预测指标。
作者获取了40例患有外斜视的儿童和20例患有睑裂斑（对照组）的儿童在全身麻醉诱导前及诱导后立即处于仰卧位时的数码照片。测量每位患者的解剖学瞳孔间距（aIPD）差异，并与术前斜视角度进行比较。还将其与术后第一天和术后1年的手术结果进行关联。
所有60例患者在全身麻醉后aIPD均增加。外斜视患者的aIPD平均变化与睑裂斑患者相似（分别为3.78%±2.53%和3.15%±1.05%）。在外斜视患者中，术前距离偏差（P）与眼位变化（A）之间存在显著的正线性相关性：A = 0.362P - 4.488，r² = 0.476（P <.001）。7例变化超出预期值80%置信区间患者中的5例（71%）术后第一天手术效果不佳，4例术后一年结果不满意。
全身麻醉后aIPD的变化与术前斜视角度密切相关。因此，它们可能是外斜视患儿手术结果的有用预测指标。
