Luk Abbie Sheung-Wan, Yam Jason Cheuk-Sing, Lau Henry Hing-Wai, Yip Wilson Wai-Kuen, Young Alvin Lerrmann
Department of Ophthalmology & Visual Sciences, 1/F Eye Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
J Ophthalmol. 2015;2015:758463. doi: 10.1155/2015/758463. Epub 2015 Mar 17.
Purpose. To evaluate the surgical outcomes of unilateral or bilateral medial rectus (MR) muscle resection for recurrent exotropia after bilateral lateral rectus (BLR) muscle recession based on a novel surgical formula. Methods. Forty-one consecutive patients with unilateral or bilateral MR muscle resection for recurrent exotropia after BLR muscle recession were included in this retrospective study. All surgeries were performed according to the formula: 1.0 mm MR muscle resection for every 5 prism dioptres (PD) of exotropia, with an addition of 0.5 mm to each MR muscle operated on. Results. The mean recurrent exotropia distant deviation was 28 PD ± 11.2 (range 14 to 55 PD). Overall at postoperative 1 month, 36 (88%) achieved successful outcomes, 4 (10%) had undercorrection, and 1 (2%) had overcorrection. At postoperative 6 months, 29 (71%) achieved successful outcomes, 12 (29%) had undercorrection, and none had overcorrection. Subgroup analysis showed no statistically significant difference in success rates between unilateral and bilateral MR groups. Conclusion. Unilateral or bilateral MR muscle resection using our surgical formula is a safe and effective method for calculating the amount of MR resection in moderate to large angle recurrent exotropia, with a low overcorrection rate.
目的。基于一种新的手术公式，评估双侧外直肌（BLR）后徙术后复发性外斜视行单侧或双侧内直肌（MR）切除术的手术效果。方法。本回顾性研究纳入了41例因BLR后徙术后复发性外斜视行单侧或双侧MR切除术的连续患者。所有手术均按照以下公式进行：每5棱镜度（PD）外斜视行1.0mm MR肌切除术，每只接受手术的MR肌额外增加0.5mm。结果。复发性外斜视远距离平均偏斜度为28 PD±11.2（范围14至55 PD）。总体而言，术后1个月时，36例（88%）取得成功结果，4例（10%）矫正不足，1例（2%）矫正过度。术后6个月时，29例（71%）取得成功结果，12例（29%）矫正不足，无矫正过度病例。亚组分析显示，单侧和双侧MR组成功率无统计学显著差异。结论。使用我们的手术公式进行单侧或双侧MR肌切除术是计算中度至大角度复发性外斜视MR切除量的一种安全有效的方法，矫正过度率低。
