Cho Soon Young, Lee Se Youp, Jung Jong Hyun
Department of Ophthalmology, Dongguk University College of Medicine, Gyeongju, Korea.
Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Korean J Ophthalmol. 2015 Dec;29(6):411-7. doi: 10.3341/kjo.2015.29.6.411. Epub 2015 Nov 25.
The purpose of this study is to compare the surgical outcomes and near stereoacuities after unilateral medial rectus (MR) muscle resection and lateral rectus (LR) recession according to deviation angle in basic intermittent exotropia, X(T).
Ninety patients with basic type X(T) were included in this study. They underwent unilateral recession of the LR and resection of the MR and were followed postoperatively for at least 12 months. Patients were divided into three groups according to their preoperative deviation angle: group 1 ≤20 prism diopter (PD), 20 PD< group 2 <40 PD, and group 3 ≥40 PD. Surgical outcomes and near stereoacuities one year after surgery were evaluated. Surgical success was defined as having a deviation angle range within ±10 PD for both near and distance fixation.
Among 90 patients, groups 1, 2, and 3 included 30 patients each. The mean age in groups 1, 2, and 3 was 9.4 years, 9.4 years, and 11.0 years, respectively. The surgical success rates one year after surgery for groups 1, 2, and 3 were 80.0%, 73.3%, and 73.3% (chi-square test, p = 0.769), respectively. The undercorrection rates for groups 1, 2, and 3 were 16.7%, 23.3%, and 26.7%, and the overcorrection rates were 3.3%, 3.3%, and 0%, respectively. The mean preoperative near stereoacuities for groups 1, 2, and 3 were 224.3 arcsec, 302.0 arcsec, and 1,107.3 arcsec, and the mean postoperative near stereoacuities were 218.3 arcsec, 214.7 arcsec, and 743.0 arcsec (paired t-test; p = 0.858, p = 0.379, p = 0.083), respectively.
In basic X(T) patients, the amount of angle deviation has no influence on surgical outcomes in unilateral LR recession and MR resection. The near stereoacuities by one year after LR recession and MR resection for intermittent X(T) were not different among patient groups separated by preoperative deviation angle.
本研究旨在比较在基本型间歇性外斜视（X(T)）中，根据偏斜角度行单侧内直肌（MR）缩短术和外直肌（LR）后徙术的手术效果及近立体视锐度。
本研究纳入90例基本型X(T)患者。他们接受了单侧LR后徙术和MR缩短术，并在术后随访至少12个月。根据术前偏斜角度将患者分为三组：第1组≤20棱镜度（PD），第2组20 PD＜第2组＜40 PD，第3组≥40 PD。评估手术效果及术后一年的近立体视锐度。手术成功定义为近距和远距注视时偏斜角度范围在±10 PD内。
90例患者中，第1、2、3组各有30例。第1、2、3组的平均年龄分别为9.4岁、9.4岁和11.0岁。第1、2、3组术后一年的手术成功率分别为80.0%、73.3%和73.3%（卡方检验，p = 0.769）。第1、2、3组的欠矫率分别为16.7%、23.3%和26.7%，过矫率分别为3.3%、3.3%和0%。第1、2、3组术前近立体视锐度的平均值分别为224.3角秒、302.0角秒和1107.3角秒，术后近立体视锐度的平均值分别为218.3角秒、214.7角秒和743.0角秒（配对t检验；p = 0.858，p = 0.379，p = 0.083）。
在基本型X(T)患者中，偏斜角度大小对单侧LR后徙术和MR缩短术的手术效果无影响。对于间歇性X(T)患者，LR后徙术和MR缩短术后一年的近立体视锐度在根据术前偏斜角度分组的患者组间无差异。
