眼肌型重症肌无力患者斜视手术的长期随访。
Long-term follow-up of strabismus surgery for patients with ocular myasthenia gravis.
机构信息
Department of Ophthalmology, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, CA 90095, USA.
出版信息
J Neuroophthalmol. 2013 Mar;33(1):40-4. doi: 10.1097/WNO.0b013e318280d630.
BACKGROUND
Patients with ocular myasthenia gravis (OMG) may develop strabismus and diplopia. We completed a retrospective observational case series to evaluate long-term surgical outcomes in patients with OMG.
METHODS
The medical records of all patients with OMG who underwent strabismus surgery with at least 6 months of postoperative follow-up were reviewed. Nine patients met the study inclusion criteria. The main outcomes, including ocular alignment, number of surgeries, and sensory status were evaluated.
RESULTS
Of these patients, initially 2 had horizontal strabismus alone, 3 had vertical strabismus alone, 3 had both vertical and horizontal strabismus, and 1 patient had vertical and torsional strabismus. The length of preoperative stability was 2.0 ± 2.5 years (range: 0.1-8.0 years). The mean preoperative horizontal and vertical deviations were 40.5 ± 32.5 prism diopters (PD; range: 0-90 PD) and 25.6 ± 36.7 PD (range: 0-120 PD), respectively. The average length of the follow-up after the first surgery was 5.7 ± 4.2 years (range: 0.7-10.6 years). Four patients (44%) underwent 2 operations. For patients requiring a second operation, the time to second operation was 2.3 years (range: 0.4-5.0 years). Six patients (67%) were within 10 PD of orthotropia at distance in primary position at the final visit. Five patients (55%) had single vision after their surgeries.
CONCLUSION
Strabismus surgery can achieve good long-term binocular alignment in patients with OMG.
背景
眼肌型重症肌无力（OMG）患者可能会出现斜视和复视。我们完成了一项回顾性观察性病例系列研究，以评估 OMG 患者斜视手术的长期手术结果。
方法
回顾性分析了所有至少有 6 个月术后随访的 OMG 患者接受斜视手术的病历。9 名患者符合研究纳入标准。评估了主要结果，包括眼位、手术次数和感觉状态。
结果
这些患者中，最初 2 例为单纯水平斜视，3 例为单纯垂直斜视，3 例为垂直和水平斜视，1 例为垂直和扭转斜视。术前稳定期长度为 2.0 ± 2.5 年（范围：0.1-8.0 年）。术前水平和垂直偏差的平均值分别为 40.5 ± 32.5 棱镜度（PD；范围：0-90 PD）和 25.6 ± 36.7 PD（范围：0-120 PD）。第一次手术后的平均随访时间为 5.7 ± 4.2 年（范围：0.7-10.6 年）。4 名患者（44%）接受了 2 次手术。对于需要第二次手术的患者，第二次手术的时间为 2.3 年（范围：0.4-5.0 年）。6 名患者（67%）在最终随访时在第一眼位的远距离达到 10 PD 内正位。5 名患者（55%）在手术后具有单眼视力。
结论
斜视手术可以使 OMG 患者获得良好的长期双眼正位。
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