Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
Br J Ophthalmol. 2014 Oct;98(10):1414-9. doi: 10.1136/bjophthalmol-2014-304876. Epub 2014 May 13.
To compare preoperative and postoperative distance deviation angle in recurrent exotropes, and to determine factors associated with large-angle recurrent exotropia.
In recurrent exotropes who were followed-up more than 2 years postoperatively, the largest angle after recurrence (LAAR) was compared with the preoperative deviation angle (PA). Patients were classified into those who had LAAR<PA and LAAR≥PA. Differences in clinical factors between groups were examined.
Among 242 exotropes who underwent surgery, and followed-up for more than 2 years postoperatively, 83 showed recurrent exotropia. Mean age at surgery was 5.7 ± 2.4 years, and mean postoperative follow-up was 36.2 ± 11.3 months. The bigger the preoperative angle, the bigger the angle of recurrence is. However, the smaller the preoperative angle, the angle of recurrence grows closer to the preoperative one. Only six showed bigger recurrence (LAAR≥PA), and these patients had a smaller mean preoperative angle (p=0.01) compared to patients whose angle of recurrence was smaller than the preoperative one. Among the patients with LAAR<PA, type of exotropia (p=0.03) and preoperative constant deviation (p=0.02) was associated with PA-LAAR≤5(Δ).
Although the overall incidence of recurrent exotropia with a relatively large angle (LAAR≥PA) is low among patients who underwent surgery for exotropia (2.5%), the possibility of this phenomenon should be noted. The ratio of relatively large angle recurrence was higher in patients with a small preoperative exodeviation and basic type exotropia.
比较复发外斜视患者术前和术后的距离偏斜角，并确定与大角度复发外斜视相关的因素。
在术后随访超过 2 年的复发外斜视患者中，比较最大复发角（LAAR）与术前偏斜角（PA）。将患者分为 LAAR<PA 和 LAAR≥PA 两组。检查两组间临床因素的差异。
在 242 例接受手术并随访超过 2 年的外斜视患者中，83 例出现复发外斜视。手术时的平均年龄为 5.7±2.4 岁，术后平均随访时间为 36.2±11.3 个月。术前角度越大，复发角度越大。然而，术前角度越小，复发角度越接近术前角度。只有 6 例出现较大的复发（LAAR≥PA），这些患者的术前平均角度较小（p=0.01），与复发角度小于术前角度的患者相比。在 LAAR<PA 的患者中，斜视类型（p=0.03）和术前恒定性偏斜（p=0.02）与 PA-LAAR≤5（Δ）相关。
尽管在接受外斜视手术的患者中，出现相对大角度（LAAR≥PA）的复发性斜视总体发生率相对较低（2.5%），但仍应注意这种现象的可能性。术前外斜视较小和基本型外斜视患者中，相对大角度复发的比例较高。
