Agrawal Siddharth, Singh Vinita, Gupta Sanjiv Kumar, Agrawal Saurabh
Department of Ophthalmology, King Georges' Medical University, Lucknow, Uttar Pradesh, India.
Sukriti Eye Clinic, Lucknow, Uttar Pradesh, India.
Oman J Ophthalmol. 2013 Sep;6(3):165-9. doi: 10.4103/0974-620X.122270.
To evaluate a simplified method for correction of ocular deviation in patients of infantile and acquired basic esotropia.
Thirty-six consecutive patients of infantile and acquired basic esotropia were selected for this study. Patients underwent unilateral recession-resection surgery as per the new norm gram. Patients underwent 3.5-7 mm recession of medial rectus (MR) in one eye depending on the pre-operative deviation and patient's age. Together they also underwent 6 or 7 mm resection of the lateral rectus (LR) in the same eye depending on patient's age (6 mm for 3 years and below and 7 mm for older age). In patients 3 years and below, a correction of 6, 7, or 8 PD/mm of recession of MR was expected when the pre-operative deviation was lesser than 30 PD, between 30 and 60 PD, or above 60 PD, respectively. Similarly, these values were 5, 6, and 7 PD/mm of MR recession in patients above 3 years. A ratio between achieved and expected correction was calculated and the calculation was deemed successful for a patient if this ratio fell between 0.9 and 1.1.
Thirty-six consecutive patients of infantile and acquired basic esotropia were selected for this study. Patients underwent unilateral recession-resection surgery as per the new norm gram. Patients underwent 3.5-7 mm recession of medial rectus (MR) in one eye depending on the pre-operative deviation and patient's age. Together they also underwent 6 or 7 mm resection of the lateral rectus (LR) in the same eye depending on patient's age (6 mm for 3 years and below and 7 mm for older age). In patients 3 years and below, a correction of 6, 7, or 8 PD/mm of recession of MR was expected when the pre-operative deviation was lesser than 30 PD, between 30 and 60 PD, or above 60 PD, respectively. Similarly, these values were 5, 6, and 7 PD/mm of MR recession in patients above 3 years. A ratio between achieved and expected correction was calculated and the calculation was deemed successful for a patient if this ratio fell between 0.9 and 1.1.
The calculation procedure was successful in 33 out of 36 patients (91%). The two-tailed probability on paired Wilcoxon test was 0.187.
This simplified method of surgical dosage calculation using MR recession as basis is predictable in patients of infantile and basic Esotropia. It may serve as a useful tool for minimizing variability of surgical results.
评估一种用于矫正婴儿型和后天性基本内斜视患者眼位偏斜的简化方法。
本研究选取了36例连续性婴儿型和后天性基本内斜视患者。患者按照新的规范图表接受单侧后徙-切除术。根据术前斜视度数和患者年龄，一只眼睛的内直肌后徙3.5 - 7毫米。同样根据患者年龄，同一只眼睛的外直肌还需切除6或7毫米（3岁及以下为6毫米，年龄较大者为7毫米）。对于3岁及以下患者，术前斜视度数小于30棱镜度（PD）、30至60 PD、大于60 PD时，预期内直肌后徙每毫米分别矫正6、7或8 PD。同样，3岁以上患者内直肌后徙每毫米矫正量分别为5、6和7 PD。计算实际矫正量与预期矫正量的比值，若该比值在0.9至1.1之间，则认为该患者的计算成功。
本研究选取了36例连续性婴儿型和后天性基本内斜视患者。患者按照新的规范图表接受单侧后徙-切除术。根据术前斜视度数和患者年龄，一只眼睛的内直肌后徙3.5 - 7毫米。同样根据患者年龄，同一只眼睛的外直肌还需切除6或7毫米（3岁及以下为6毫米，年龄较大者为7毫米）。对于3岁及以下患者，术前斜视度数小于30棱镜度（PD）、30至60 PD、大于60 PD时，预期内直肌后徙每毫米分别矫正6、7或8 PD。同样，3岁以上患者内直肌后徙每毫米矫正量分别为5、6和7 PD。计算实际矫正量与预期矫正量的比值，若该比值在0.9至1.1之间，则认为该患者的计算成功。
36例患者中有33例（91%）计算过程成功。配对威尔科克森检验的双侧概率为0.187。
这种以内直肌后徙为基础的简化手术剂量计算方法在婴儿型和基本型内斜视患者中具有可预测性。它可能是减少手术结果变异性的有用工具。
