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基本型间歇性外斜视的术后斜视控制与眼肌矫正

Post-operative strabismus control and motor alignment for basic intermittent exotropia.

作者信息

Chew Fiona Lee Min, Gesite-de Leon Bhambi Uellyn, Quah Boon Long

机构信息

Department of Ophthalmology, Singapore National Eye Centre, 11, Third Hospital Avenue 168751, Singapore.

出版信息

Int J Ophthalmol. 2016 Jul 18;9(7):1011-5. doi: 10.18240/ijo.2016.07.13. eCollection 2016.

Abstract

AIM

To assess strabismus control and motor ocular alignment for basic exotropia surgery at 5y follow-up.

METHODS

The medical records of 80 consecutive patients aged less than 17 years of age, who underwent surgery for basic exotropia by a single surgeon between years 2000 to 2009 and completed a minimum of 5y follow-up post-operatively were reviewed. Pre- and post-operative characteristics were documented at 1wk, 6mo, 1, 3 and 5y follow-up. Subjects at 5-year follow-up were assigned to the success group if they had a post-operative angle of deviation within 10 prism diopters of exotropia or within 5 prism diopters of esotropia for distance on prism cover test, and had moderate to good strabismus control. The remaining subjects were assigned to the failure group.

RESULTS

Post-operative surgical success at one week was 75%, which decreased to 41% at 5y follow-up. The success group was noted to have more patching pre-operatively (P=0.003). The duration of patching a day (P=0.020) and total duration of patching pre-operatively (P=0.030) was higher in the success group. Surgical success at 1y (P=0.004) and 3y (P=0.002) were associated with higher surgical success at 5y follow-up.

CONCLUSION

Post-operative motor alignment and strabismus control for basic exotropia surgery at 1y and beyond is associated with higher exotropia surgery success at 5-year follow-up. There is an association between pre-operative patching and 5-year surgical success of basic intermittent exotropia surgery.

摘要

目的

评估在5年随访期内基本外斜视手术的斜视控制情况及眼位运动性矫正。

方法

回顾了2000年至2009年间由同一位外科医生为80例年龄小于17岁的连续患者进行基本外斜视手术且术后至少完成5年随访的病历。在术后1周、6个月、1年、3年和5年随访时记录术前和术后特征。在5年随访时,棱镜遮盖试验检查远距离时,如果患者术后外斜视角偏差在10三棱镜度以内或内斜视角偏差在5三棱镜度以内,且斜视控制为中度至良好,则将其归入成功组。其余患者归入失败组。

结果

术后1周手术成功率为75%,5年随访时降至41%。成功组术前接受更多眼罩遮盖治疗(P=0.003)。成功组每日眼罩遮盖时长(P=0.020)及术前眼罩遮盖总时长(P=0.030)更长。术后1年(P=0.004)和3年(P=0.002)手术成功与5年随访时更高的手术成功率相关。

结论

基本外斜视手术术后1年及以后的眼位运动性矫正和斜视控制与5年随访时更高的外斜视手术成功率相关。术前眼罩遮盖治疗与基本间歇性外斜视手术的5年手术成功率之间存在关联。

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