单侧外直肌后徙术后的长期手术效果及复发因素
Long-term surgical outcomes and factors for recurrence after unilateral lateral rectus muscle recession.
作者信息
Lyu In Jeong, Park Kyung-Ah, Oh Sei Yeul
机构信息
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Ophthalmology, Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Br J Ophthalmol. 2016 Oct;100(10):1433-6. doi: 10.1136/bjophthalmol-2015-307970. Epub 2016 Jan 14.
AIM
To evaluate long-term surgical outcomes and risk factors for recurrence after unilateral lateral rectus muscle recession (ULR) in children with small to moderate angle intermittent exotropia (IXT).
METHODS
214 patients with basic type IXT of 15-24 prism dioptres (PD) who underwent ULR were included. The main outcome measure was success rate at 2 years after surgery and at final follow-up. The risk factors related to recurrence were evaluated using univariable and multivariable logistic regression analyses.
RESULTS
Success rate at postoperative 2 years was 92.5% and at final examination after a mean follow-up of 3.9 years was 83.2%. No overcorrection was observed. Preoperative exodeviation of 20-24 PD was the significant risk factor for recurrence according to both univariable (OR=3.577, p=0.022) and multivariable analysis (OR=3.265, p=0.034).
CONCLUSIONS
The overall long-term successful alignment rate of ULR for 15-24 PD of IXT was good. However, patients with 20-24 PD of IXT showed worse prognosis compared with 15-19 PD of IXT.
目的
评估小至中度间歇性外斜视（IXT）患儿行单眼外直肌后徙术（ULR）后的长期手术效果及复发危险因素。
方法
纳入214例行ULR的15 - 24棱镜度（PD）基本型IXT患者。主要观察指标为术后2年及末次随访时的成功率。采用单因素和多因素逻辑回归分析评估与复发相关的危险因素。
结果
术后2年成功率为92.5%，平均随访3.9年后末次检查时成功率为83.2%。未观察到过矫情况。根据单因素（OR = 3.577，p = 0.022）和多因素分析（OR = 3.265，p = 0.034），术前20 - 24 PD的外斜视是复发的显著危险因素。
结论
对于15 - 24 PD的IXT，ULR的总体长期成功矫正率良好。然而，与15 - 19 PD的IXT患者相比，20 - 24 PD的IXT患者预后较差。
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