Kim M K, Kim U S, Cho M-J, Baek S-H
Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, Korea.
Eye (Lond). 2015 Dec;29(12):1555-60. doi: 10.1038/eye.2015.152. Epub 2015 Aug 21.
Purpose: To evaluate and compare surgical outcomes with respect to refractive errors in strabismus surgery for the treatment of intermittent exotropia (IXT).
The medical records of patients with IXT who were treated by one surgeon from January 2005 and June 2011 were reviewed. Three hundred and thirty-three IXT patients were included and divided into three groups according to preoperative refractive error: IXT with hyperopia (group I), IXT with emmetropia (group II), and IXT with myopia (group III). The surgical outcomes with respect to sensory and motor criteria were compared among the three groups.
The surgical success rates according to motor criteria and sensory and motor criteria combined were higher in groups I (29 patients) and III (124 patients) than in group II (180 patients) at postoperative 3 and 6 months and at the last follow-up. Stereopsis was significantly better in groups II and III than in group I preoperatively (P=0.002 by one-way analysis of variance test); however, the difference was not significant postoperatively. Twenty patients in group I (69.0%) were prescribed undercorrected hyperopic spectacles postoperatively, while only 22 patients in group III (17.7%) were prescribed spectacles with more myopic power than their refractive errors.
In the surgical treatment of IXT, hyperopia was not an indicator of poor prognosis. Taking into consideration the age effect, follow-up period after IXT surgery, and stereopsis improvement, hyperopic refractive error is rather a good prognostic factor.
目的:评估并比较斜视手术治疗间歇性外斜视(IXT)时屈光不正方面的手术效果。
回顾了2005年1月至2011年6月由一位外科医生治疗的IXT患者的病历。纳入333例IXT患者,并根据术前屈光不正分为三组:远视性IXT(I组)、正视性IXT(II组)和近视性IXT(III组)。比较三组在感觉和运动标准方面的手术效果。
术后3个月、6个月及末次随访时,I组(29例患者)和III组(124例患者)根据运动标准以及感觉和运动标准综合评估的手术成功率高于II组(180例患者)。术前II组和III组的立体视明显优于I组(单因素方差分析,P = 0.002);然而,术后差异无统计学意义。I组20例患者(69.0%)术后被开具欠矫远视眼镜处方,而III组只有22例患者(17.7%)被开具度数比其屈光不正更高的近视眼镜处方。
在IXT的手术治疗中,远视并非预后不良的指标。考虑到年龄效应、IXT手术后的随访时间以及立体视改善情况,远视性屈光不正相当于是一个良好的预后因素。