Dabes Erika M P, Weakley David R, Birch Eileen
University of Texas Southwestern Medical Center, Department of Ophthalmology, Dallas, Texas 75390-9057, USA.
J AAPOS. 2011 Jun;15(3):219-23. doi: 10.1016/j.jaapos.2011.03.006. Epub 2011 Jun 15.
Recent reports and anecdotal observations suggest that strabismus surgery, particularly for infantile esotropia, may be in decline, although a recent population-based study found the incidence to be stable.
We analyzed the surgical database of 4,494 primary pediatric strabismus procedures from 1990 through 2009 at Children's Medical Center of Dallas. Linear regression models were used to identify the relationship between the year and the proportion of each surgical category (infantile esotropia, all esotropia, exotropia, and other) using the least-squares approach.
Surgery for infantile esotropia (mean age, 10 months) was performed on 374 patients (mean, 19; range, 11-27/year). Trend analysis demonstrated no significant change in the annual rate of surgery for infantile esotropia (R(2) = 0.004) during the 20-year study period. Additionally, when compared to the annual number of births in Dallas County, no significant change in the incidence of surgically corrected infantile esotropia was noted during the study period (P = 0.25); however, surgery for both infantile esotropia (P = 0.001) and for any esotropia (P = 0.002) declined, while surgery for exotropia increased (P = 0.002) as a proportion of all primary strabismus surgeries.
The incidence of surgically corrected infantile esotropia has remained stable over a 20-year period. As a proportion of all primary strabismus procedures, surgery for all types of esotropia has decreased and for exotropia has increased.
近期的报告及传闻观察表明，斜视手术，尤其是针对婴儿型内斜视的手术，可能呈下降趋势，尽管最近一项基于人群的研究发现其发病率保持稳定。
我们分析了达拉斯儿童医学中心1990年至2009年期间4494例原发性小儿斜视手术的数据库。采用线性回归模型，运用最小二乘法确定年份与各手术类别（婴儿型内斜视、所有内斜视、外斜视及其他）比例之间的关系。
对374例患者（平均年龄10个月）实施了婴儿型内斜视手术（平均每年19例；范围为每年11 - 27例）。趋势分析显示，在20年的研究期间，婴儿型内斜视的年手术率无显著变化（R² = 0.004）。此外，与达拉斯县的年出生人数相比，研究期间手术矫正的婴儿型内斜视发病率无显著变化（P = 0.25）；然而，作为所有原发性斜视手术的比例，婴儿型内斜视手术（P = 0.001）和任何内斜视手术（P = 0.002）均有所下降，而外斜视手术则有所增加（P = 0.002）。
手术矫正的婴儿型内斜视发病率在20年期间保持稳定。作为所有原发性斜视手术的比例，各类内斜视手术减少，外斜视手术增加。
