Li Jun Hong, Zhang Li Jun
Shanxi Eye Hospital, Shanxi Medical University, Taiyuan, China.
J AAPOS. 2013 Dec;17(6):578-81. doi: 10.1016/j.jaapos.2013.07.015. Epub 2013 Nov 7.
To report the outcomes of surgery on three horizontal muscles for very large-angle constant exotropia.
In this prospective case series, consecutive adult patients with primary constant exotropia with angles ≥120(Δ) underwent strabismus surgery on three horizontal muscles. Surgery consisted of lateral rectus recession of 10-15 mm on the fixing eye in addition to lateral rectus recession of 9-13 mm and medial rectus resection of 6.5-9 mm on the nonfixing eye. The mean follow-up period was >6 months. Success was defined as horizontal eso- or exodeviations of ≤10(Δ).
A total of 23 patients were included. The mean age at surgery was 30.4 ± 9.3 years (range, 16-52). The mean preoperative near exodeviation was 128(Δ) ± 9.8(Δ); the mean preoperative distance exodeviation, 130(Δ) ± 10.4(Δ). The mean follow-up period was 8.1 ± 1.4 months. At the last follow-up, 19 of the 23 cases (83%) were successfully aligned. At final follow-up examination, the mean postoperative exodeviation was 5(Δ) ± 4.2(Δ) (near) and 5(Δ) ± 4.3(Δ) (distance); no patient had diplopia on lateral gazes.
In this patient cohort, surgery on three-muscle surgery for very large-angle exotropia successfully restored alignment in primary gaze in over 80% of cases without inducing symptomatic abduction deficits.
报告对非常大角度恒定性外斜视行三条水平肌手术的结果。
在这个前瞻性病例系列中，连续的原发性恒定性外斜视且斜视角度≥120（Δ）的成年患者接受了三条水平肌的斜视手术。手术包括对注视眼的外直肌后徙10 - 15毫米，以及对非注视眼的外直肌后徙9 - 13毫米和内直肌截除6.5 - 9毫米。平均随访期>6个月。成功定义为水平内斜视或外斜视≤10（Δ）。
共纳入23例患者。手术时的平均年龄为30.4±9.3岁（范围16 - 52岁）。术前平均近距外斜视度为128（Δ）±9.8（Δ）；术前平均远距离外斜视度为130（Δ）±10.4（Δ）。平均随访期为8.1±1.4个月。在最后一次随访时，23例中的19例（83%）实现了成功矫正。在最终随访检查时，术后平均外斜视度为近距5（Δ）±4.2（Δ）和远距离5（Δ）±4.3（Δ）；没有患者在向外侧注视时有复视。
在这个患者队列中，对非常大角度外斜视行三条肌肉手术在超过80%的病例中成功恢复了第一眼位的眼位矫正，且未引起有症状的外展功能缺陷。
