Department of Ophthalmology, Chonnam National University Medical School and Hospital, 8 Hak-Dong, Dong-Gu, Gwangju, 501-757, Korea.
Jpn J Ophthalmol. 2013 Sep;57(5):475-80. doi: 10.1007/s10384-013-0260-x. Epub 2013 Jul 6.
To compare surgical outcomes between bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession-medial rectus resection (RR) for intermittent exotropia with overcorrection of 20 prism diopter (PD) or more on postoperative day 1.
A retrospective chart review identified 319 patients who underwent either BLR or RR for primary surgical treatment of intermittent exotropia between July 2008 and June 2011. The patients with basic type intermittent exotropia and overcorrection of 20 PD or more, at either near or distance, on postoperative day 1 and had more than 6 months of follow-up were included. Patients with simultaneous vertical and/or oblique muscle surgery and those with paralytic or restrictive strabismus were excluded. The pre- and post-operative deviation, visual acuity, and near stereoacuity were analyzed.
Twenty-four patients were included. The mean postoperative day 1 alignment was 21.5 ± 6.2 PD esotropia at distance, and 13.8 ± 8.0 PD at near. Fourteen patients underwent BLR and 10 underwent RR. Three patients were wearing the base out prism below 15 PD at the last follow-up. The mean duration from the surgery to esotropia below 10 PD was 2.9 ± 1.1 weeks and 8.0 ± 7.1 weeks in the BLR and RR groups, respectively (p = 0.030). All three recurrent patients underwent RR. None of the patients completely lost stereoacuity, postoperatively.
In basic type intermittent exotropia with overcorrection of 20 PD or more on postoperative day 1, the overcorrection resolved faster and recurrence rates were lower in BLR group than in the RR group. Consecutive esotropia over 15 PD did not occur in both groups.
比较双眼外直肌后退术（BLR）与单侧外直肌后退-内直肌缩短术（RR）治疗术后第 1 天过矫正 20 棱镜度（PD）或以上的间歇性外斜视的手术效果。
回顾性分析 2008 年 7 月至 2011 年 6 月期间因原发性间歇性外斜视接受 BLR 或 RR 治疗的 319 例患者的病历。纳入基本型间歇性外斜视，术后第 1 天近距和（或）远距过矫正 20 PD 或以上，且随访时间超过 6 个月的患者。排除同时行垂直肌和/或斜肌手术以及麻痹性或限制性斜视的患者。分析术前和术后的偏斜度、视力和近立体视锐度。
共纳入 24 例患者。远距平均术后第 1 天的矫正眼位为 21.5 ± 6.2 PD 内斜视，近距为 13.8 ± 8.0 PD。14 例行 BLR，10 例行 RR。3 例患者在最后一次随访时戴底向外 15 PD 以下棱镜。BLR 和 RR 组眼位由正转至 10 PD 以下的平均时间分别为 2.9 ± 1.1 周和 8.0 ± 7.1 周（p = 0.030）。3 例复发患者均行 RR。术后无患者完全丧失立体视锐度。
对于术后第 1 天过矫正 20 PD 或以上的基本型间歇性外斜视，BLR 组的过矫正消退更快，复发率更低。两组均未出现连续的 15 PD 以上内斜视。
