Choi Yong-Min, Lee Joo-Yeon, Jung Jae-Hoon, Kim Seung-Hyun, Cho Yoonae A
J Pediatr Ophthalmol Strabismus. 2013 Nov-Dec;50(6):335-9. doi: 10.3928/01913913-20130903-01. Epub 2013 Sep 10.
To evaluate the risk factors predicting surgical treatment in consecutive esotropia occurring after surgery for intermittent exotropia.
The clinical records of 52 patients with consecutive esotropia who underwent exotropia surgery were retrospectively reviewed. All patients demonstrated consecutive esotropia with diplopia or suppression for more than 1 month after surgery for exotropia. Patients were divided into two groups (the surgical group and nonsurgical group) depending on whether surgery was required for consecutive esotropia. Surgery for esotropia was performed only in patients with more than 10 prism diopters (PD) esodeviation that persisted for a minimum of 6 months, those who had suppression in 1 eye or diplopia, and those who could not achieve fine stereopsis. The nonsurgical treatment up to 6 months postoperatively was part-time patching and prism therapy in both groups. Patient characteristics were evaluated in the two groups.
The surgical group was composed of 17 patients and the nonsurgical group was composed of 35 patients. Age, gender, refractive error, best-corrected visual acuity, and postoperative overcorrection at 1 day were not significantly different in the two groups (P > .05). However, the distance strabismic angle at 1 month postoperatively was 2.5 ± 3.8 PD esodeviation (range: 14 PD esotropia to 4 PD exotropia) in the nonsurgical group and 5.4 ± 5.1 PD esodeviation (range: 20 PD esotropia to orthotropia) in the surgical group; these values were statistically significant (P < .05).
The clinically significant risk factor affecting the surgical decision for consecutive esotropia was a large esotropic angle at 1 month postoperatively in this study.
评估间歇性外斜视手术后发生连续性内斜视的手术治疗预测危险因素。
回顾性分析52例行外斜视手术的连续性内斜视患者的临床记录。所有患者在接受外斜视手术后均出现连续性内斜视伴复视或抑制超过1个月。根据连续性内斜视是否需要手术，将患者分为两组（手术组和非手术组）。仅对那些内斜度超过10棱镜度（PD）且持续至少6个月、单眼抑制或复视以及无法获得精细立体视的患者进行内斜视手术。两组术后6个月内的非手术治疗均为部分时间遮盖和棱镜治疗。对两组患者的特征进行评估。
手术组由17例患者组成，非手术组由35例患者组成。两组患者的年龄、性别、屈光不正、最佳矫正视力和术后1天的过矫情况无显著差异（P>.05）。然而，非手术组术后1个月的远距离斜视角度为2.5±3.8 PD内斜（范围：14 PD内斜视至4 PD外斜视），手术组为5.4±5.1 PD内斜（范围：20 PD内斜视至正位）；这些值具有统计学意义（P<.05）。
在本研究中，影响连续性内斜视手术决策的临床显著危险因素是术后1个月时较大的内斜角度。
