Nabie Reza, Azadeh Minoo, Andalib Dima, Mohammadlou Farzin Soltan
Department of Ophthalmology, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
J AAPOS. 2011 Dec;15(6):532-5. doi: 10.1016/j.jaapos.2011.05.025.
To compare the results of conventional hang-back and anchored hang-back technique for bilateral lateral rectus muscle recessions in patients with exotropia.
In a prospective, randomized clinical study, 60 patients underwent lateral rectus muscle recession by either conventional hang-back or anchored hang-back technique. Patients were then followed for 6 months; postoperative deviation and complications were compared. Surgery was considered successful if the postoperative deviation was within 10(Δ) of orthophoria.
The mean age of patients was 14.2 ± 10.3 years (median, 12 years) in the conventional hang-back group and 11.5 ± 9.3 years (median, 8 years) in anchored group (P = 0.85). The mean preoperative deviation at distance and near between the 2 groups was not statistically significant. The mean postoperative deviation was 8(Δ) ± 9(Δ) at distance and 7(Δ) ± 9(Δ) at near in the conventional group and 9(Δ) ± 8(Δ) at distance and 8(Δ) ± 8(Δ) at near in the anchored group. (P = 0.48 for distance, P = 0.98 for near). After 6 months, 63% of the conventional group and 60% of the anchored group were within 10(Δ) of orthophoria. Complications such as globe perforation, A and V patterns, and vertical deviations did not occur in either group. There were no statistically significant differences in the success rates (P = 0.79) or complications between the 2 groups.
The placement of additional posterior scleral sutures to "anchor" the insertion did not improve outcomes in lateral rectus muscle recession surgery.
比较传统后徙法与锚定后徙法治疗外斜视患者双侧外直肌后徙术的效果。
在一项前瞻性随机临床研究中，60例患者采用传统后徙法或锚定后徙法行外直肌后徙术。术后对患者进行6个月的随访，比较术后斜视度及并发症情况。若术后斜视度在正位视10（Δ）范围内，则认为手术成功。
传统后徙组患者的平均年龄为14.2±10.3岁（中位数12岁），锚定组为11.5±9.3岁（中位数8岁）（P = 0.85）。两组术前远距离和近距离的平均斜视度差异无统计学意义。传统组术后远距离平均斜视度为8（Δ）±9（Δ），近距离为7（Δ）±9（Δ）；锚定组术后远距离平均斜视度为9（Δ）±8（Δ），近距离为8（Δ）±8（Δ）。（远距离P = 0.48，近距离P = 0.98）。6个月后，传统组63%的患者和锚定组60%的患者斜视度在正位视10（Δ）范围内。两组均未发生眼球穿孔、A和V征以及垂直斜视等并发症。两组的成功率（P = 0.79）及并发症发生率差异均无统计学意义。
在外侧直肌后徙术中增加后巩膜缝线“锚定”肌止端并不能改善手术效果。
