Sharma Ananda K, Thapa Madhu, Shrestha Gulshan B, Sitaula Sanjeeta, Shrestha Gauri S
BP Koirala Lion's Center for Ophthalmic Studies, Maharajgunj, Kathmandu, Nepal.
Nepal J Ophthalmol. 2014 Jul-Dec;6(2):162-9. doi: 10.3126/nepjoph.v6i2.11704.
A clinical audit of strabismus surgery in children in terms of functional and cosmetic outcomes helps improve the quality of services in pediatric ophthalmology.
To evaluate the outcome of strabismus surgery and assess the satisfaction of the patients' parents with respect to the surgery outcome.
A study of an interventional series of cases that included 60 strabismic subjects was carried out. The bilateral strabismus surgery under general anesthesia was performed on all subjects using the fornix approach. The parents' understanding about strabismus and the cosmetic outcome was assessed through a set of interview questionnaires. The main outcome measures were the amount of deviation, the parents' knowledge about strabismus and their satisfaction after the intervention.
Of the 60 subjects, 32 (53.3%) were esotropic and 28 (46.7%) exotropic. The male to female ratio was 1:1. The mean age with standard deviation was 16.6±8.5 years,with a range of 3 to 35 years. The pre- operative mean esotropia with standard deviation was 48.2±14.8 pd, with a range of 22 to 114 pd). The pre-operative mean exotropia was 57.8±14.2 pd, with a range of 25 to 90 pd). In 93.47% of the subjects, the ocular deviation after surgery reduced significantly (p=less than 0.00). After the strabismus surgery, orthophoria was achieved in 15 (25%) subjects, and with excellent cosmetics. After surgery, gross binocular single vision was attained in 39.3% of the exotropes and in 17.9% of the esotropes. Only 30% of the parents were aware about the strabismus and the treatment modalities. Nearly 90% of the parents were satisfied with the cosmetic outcome.
Horizontal and bilateral strabismus has good surgical outcome with improved cosmetic acceptance.
对儿童斜视手术的功能和美容效果进行临床审计有助于提高小儿眼科服务质量。
评估斜视手术的效果,并评估患者父母对手术效果的满意度。
对60例斜视患者进行了一项干预性系列病例研究。所有受试者均采用穹窿部入路在全身麻醉下进行双眼斜视手术。通过一组访谈问卷评估父母对斜视和美容效果的了解情况。主要结局指标为斜视度数、父母对斜视的了解程度以及干预后的满意度。
60例受试者中,32例(53.3%)为内斜视,28例(46.7%)为外斜视。男女比例为1:1。平均年龄(标准差)为16.6±8.5岁,范围为3至35岁。术前平均内斜度数(标准差)为48.2±14.8棱镜度,范围为22至114棱镜度。术前平均外斜度数为57.8±14.2棱镜度,范围为25至90棱镜度。93.47%的受试者术后眼位偏斜明显减轻(p<0.00)。斜视手术后,15例(25%)受试者达到正位,且美容效果良好。术后,39.3%的外斜视患者和17.9%的内斜视患者获得了粗略的双眼单视。只有30%的父母了解斜视及其治疗方式。近90%的父母对美容效果满意。
水平和双眼斜视手术效果良好,美容接受度提高。