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大角度婴儿型内斜视三种水平肌手术的中期疗效

Medium-term outcomes of three horizontal muscle surgery in large-angle infantile esotropia.

作者信息

Bayramlar Hüseyin, Karadag Remzi, Yildirim Aydin, Oçal Ayse, Sari Unsal, Dag Yasar

出版信息

J Pediatr Ophthalmol Strabismus. 2014 May-Jun;51(3):160-4. doi: 10.3928/01913913-20140318-02. Epub 2014 Mar 25.

Abstract

PURPOSE

To evaluate the medium-term motor outcomes of three horizontal muscle surgery in patients with large-angle infantile esotropia.

METHODS

The charts of 18 patients with large-angle (> 55 prism diopters [PD]) infantile esotropia who underwent bilateral medial rectus muscle recession and one lateral rectus muscle resection were retrospectively reviewed. Preoperative and postoperative deviations at last examination, overcorrections and undercorrections, necessity of additional horizontal surgery, and follow-up durations were recorded.

RESULTS

The median age of patients at surgery was 22 months (range: 10 to 168 months). Orthotropia to within 10 PD or less was achieved in 14 of 18 patients (78%) in a median follow-up of 32 months (range: 5 to 63 months). The mean preoperative deviation of 68.8 ± 9.54 PD decreased to a median of 1 PD (range: esotropia 30 to exophoria 4 PD) postoperatively (P < .005). Marked residual esotropia necessitating additional surgery occurred in 4 patients, but significant overcorrection was not observed.

CONCLUSIONS

The success rate of the three horizontal muscle surgeries appears to be high enough in medium-term follow-up in patients with large-angle infantile esotropia. Overcorrection that necessitates additional horizontal muscle surgery does not seem to be significant in the medium term, according to this study.

摘要

目的

评估大角度婴儿型内斜视患者接受三种水平肌手术的中期运动结局。

方法

回顾性分析18例大角度(>55棱镜度[PD])婴儿型内斜视患者的病历,这些患者接受了双侧内直肌后徙术和一侧外直肌切除术。记录末次检查时的术前和术后斜视度、过矫和欠矫情况、额外水平肌手术的必要性以及随访时间。

结果

手术时患者的中位年龄为22个月(范围:10至168个月)。18例患者中有14例(78%)在中位随访32个月(范围:5至63个月)时达到10 PD或更小的正位。术前平均斜视度为68.8±9.54 PD,术后降至中位值1 PD(范围:内斜视30至外斜视4 PD)(P<.005)。4例患者出现明显的残余内斜视需要再次手术,但未观察到明显的过矫。

结论

在大角度婴儿型内斜视患者的中期随访中,三种水平肌手术的成功率似乎足够高。根据本研究,中期内需要额外水平肌手术的过矫情况似乎并不明显。

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