Magli Adriano, Rombetto Luca, Matarazzo Francesco, Carelli Roberta
Department of Ophthalmology, Orthoptics and Pediatric Ophthalmology, University of Salerno, Salerno.
Department of Ophthalmology, Federico II University, Naples, Italy.
Clin Ophthalmol. 2016 Oct 20;10:2079-2083. doi: 10.2147/OPTH.S116103. eCollection 2016.
The aim of this study was to identify clinical and demographic factors associated with misalignment after first surgery performed on children affected by infantile esotropia to evaluate the reoperation rate. A retrospective study was carried out, analyzing data from 525 children who underwent bilateral medial recti recession, bilateral lateral recti resection, and inferior oblique recession and anteroposition by the same surgeon (AM). Postoperative evaluation included assessment of motor alignment at approximately 3 months, 6 months, 1 year, and 5 years. Statistical analysis was performed with a logistical regression model in which the dependent variable was the presence/absence of reoperation. We found that late surgery (after 3 years of age) and a family history of strabismus are associated with a higher risk of reoperation, while some clinical factors, including some classically associated with worst motor outcome as preoperative angle, dissociated vertical deviation, and amblyopia, did not influence the incidence of reoperation in infantile esotropia. Male patients and patients with hyperopia in preoperative examinations have a significantly decreased reoperation rate.
本研究的目的是确定与婴儿型内斜视患儿首次手术后眼位偏斜相关的临床和人口统计学因素，以评估再次手术率。进行了一项回顾性研究，分析了由同一位外科医生（AM）实施双侧内直肌后徙术、双侧外直肌切除术以及下斜肌后徙和前徙术的525例患儿的数据。术后评估包括在大约3个月、6个月、1年和5年时对眼位的评估。采用逻辑回归模型进行统计分析，其中因变量为是否再次手术。我们发现，手术较晚（3岁以后）和斜视家族史与再次手术的较高风险相关，而一些临床因素，包括一些经典的与最差运动结局相关的因素，如术前斜视角度、分离性垂直偏斜和弱视，并未影响婴儿型内斜视再次手术的发生率。男性患者以及术前检查有远视的患者再次手术率显著降低。
