Na Kun-Hoo, Kim Seung-Hyun
J Pediatr Ophthalmol Strabismus. 2016 Mar-Apr;53(2):99-104. doi: 10.3928/01913913-20160122-05. Epub 2016 Feb 4.
To evaluate the long-term surgical outcomes and the clinical features between infantile-onset constant and intermittent exotropia.
The medical records of 67 patients diagnosed as having infantile exotropia before 12 months of age who underwent surgery were reviewed retrospectively. Patients were divided into intermittent exotropia and constant exotropia groups based on presentation before surgery. All patients underwent bilateral lateral rectus recession. Preoperative and postoperative clinical features were investigated.
There were 37 children in the intermittent exotropia group and 30 children in the constant exotropia group. The cumulative probabilities of success 3 years after bilateral lateral rectus recession were 91.9% in the intermittent exotropia group and 70% in the constant exotropia group. Constant deviation was more closely associated with both dissociated vertical deviation (DVD) and inferior oblique muscle overaction (IOOA) (P = .009 and P = .009, respectively) and related to poor stereopsis outcome (P = .002) and distance suppression (P = .029).
Constant deviation was associated with the development of recurrence, DVD/IOOA, and poor stereopsis after surgery. Constancy of exotropia is a reliable factor for predicting poor surgical outcomes in infantile exotropia at long-term follow-up.
评估婴儿期发病的恒定性和间歇性外斜视的长期手术效果及临床特征。
回顾性分析67例12个月龄前诊断为婴儿型外斜视并接受手术治疗的患者的病历资料。根据术前表现将患者分为间歇性外斜视组和恒定性外斜视组。所有患者均接受双侧外直肌后徙术。对术前和术后的临床特征进行研究。
间歇性外斜视组有37例患儿，恒定性外斜视组有30例患儿。双侧外直肌后徙术后3年的累积成功率，间歇性外斜视组为91.9%，恒定性外斜视组为70%。恒定性斜视与分离性垂直偏斜（DVD）和下斜肌亢进（IOOA）均密切相关（分别为P = 0.009和P = 0.009），且与立体视功能不良（P = 0.002）和远距离抑制（P = 0.029）有关。
恒定性斜视与术后复发、DVD/IOOA的发生以及立体视功能不良有关。在长期随访中，外斜视的恒定性是预测婴儿型外斜视手术效果不佳的可靠因素。
