Yam Jason C S, Wu Patrick K W, Chong Gabriela S L, Wong Ursula S F, Chan Clement W N, Ko Simon T C
Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong.
J AAPOS. 2012 Jun;16(3):274-9. doi: 10.1016/j.jaapos.2012.01.005.
To compare postoperative drift after bilateral lateral rectus recession for infantile exotropia (XT) and for intermittent XT and to compare initial postoperative alignment with long-term motor outcome.
Medical records of all patients with infantile exotropia or intermittent exotropia who had undergone bilateral lateral rectus muscle recession surgery with a follow-up longer than 3 years were reviewed. The pre- and postoperative angles of deviation at distance and at near and postoperative drift at distance were compared. Surgical outcome was categorized as "success" (esotropia <6(Δ) or exotropia <11(Δ)), "recurrence" (>10(Δ) exotropia), or "overcorrection" (>5(Δ) of esotropia).
The overall mean postoperative exotropic drift at 3 years was 10.4(Δ) in the infantile XT group and 7.2(Δ) in the intermittent XT group (P = 0.05). Both groups had a low success rate at 3 years: 41% in the infantile XT group and 51% in the intermittent XT group (P = 0.270). For patients with an initial esotropia of 0(Δ) to 10(Δ), the success rate at 3 years was 86% in the infantile XT group (12 of 14) and 65% in the intermittent XT group (28 of 43).
Postoperative exotropic drift is clinically similar in patients with intermittent versus infantile exotropia. Esotropia of 0(Δ) to 10(Δ) during the early postoperative period may be associated with the best long-term ocular alignment.
比较双侧外直肌后徙术治疗婴儿型外斜视（XT）和间歇性XT后的术后漂移情况，并比较初始术后眼位矫正与长期运动结果。
回顾所有接受双侧外直肌后徙术且随访时间超过3年的婴儿型外斜视或间歇性外斜视患者的病历。比较术前和术后远距离及近距离的斜视角度以及术后远距离的漂移情况。手术结果分为“成功”（内斜视<6棱镜度（Δ）或外斜视<11棱镜度）、“复发”（外斜视>10棱镜度）或“过矫”（内斜视>5棱镜度）。
婴儿型XT组3年时总体平均术后外斜视漂移为10.4棱镜度，间歇性XT组为7.2棱镜度（P = 0.05）。两组3年时成功率均较低：婴儿型XT组为41%，间歇性XT组为51%（P = 0.270）。对于初始内斜视度数为0（Δ）至10（Δ）的患者，婴儿型XT组3年时成功率为86%（14例中的12例），间歇性XT组为65%（43例中的28例）。
间歇性外斜视与婴儿型外斜视患者术后的外斜视漂移在临床上相似。术后早期内斜视度数为0（Δ）至10（Δ）可能与最佳的长期眼位矫正相关。
