Yurdakul Nazife Sefi, Bodur Seda, Koç Feray
Atatürk Education and Research Hospital, Clinic of Ophthalmology, İzmir, Turkey.
Turk J Ophthalmol. 2015 Oct;45(5):197-202. doi: 10.4274/tjo.60973. Epub 2015 Oct 5.
To evaluate the results of symmetric and asymmetric surgery and responses to surgical amounts in patients with infantile esotropia.
The records of patients with infantile esotropia who underwent bilateral medial rectus recession (symmetric surgery) and unilateral medial rectus recession with lateral rectus resection (asymmetric surgery) were analyzed. The results of the cases with symmetric (group 1) and asymmetric (group 2), successful (group 3) and failed (group 4) surgeries were compared, and responses to the amount of surgery were investigated.
There were no significant differences between group 1 (n=71) and group 2 (n=13) cases in terms of gender, refraction, preoperative distance deviation, anisometropia and postoperative deviation angles, binocular vision, surgical success or follow-up period (p>0.05). The rate of amblyopia, near deviation and amount of surgery were higher in group 2 cases (p<0.05). Between group 3 (n=64) and group 4 subjects (n=20), no significant differences were detected in terms of gender, surgical age, refraction, amblyopia, anisometropia, preoperative deviation angles, the number of symmetric and asymmetric surgeries, the amount of surgery, or postoperative binocular vision (p>0.05). The average postoperative follow-up period was 15.41±19.93 months (range, 6-98 months) in group 3 cases and 40.45±40.06 months (range, 6-143 months) in group 4 cases (p=0.000). No significant difference was detected in the amount of deviation corrected per 1 mm of surgical procedure between the successful cases in the symmetric and asymmetric groups (p>0.05).
Symmetric or asymmetric surgery may be preferable in patients with infantile esotropia according to the clinical features. It is necessary for every clinic to review its own dose-response results.
评估婴儿型内斜视患者对称手术和不对称手术的效果以及对手术量的反应。
分析接受双侧内直肌后徙术（对称手术）和单侧内直肌后徙联合外直肌切除术（不对称手术）的婴儿型内斜视患者的病历。比较对称组（第1组）和不对称组（第2组）、手术成功组（第3组）和手术失败组（第4组）的病例结果，并研究对手术量的反应。
第1组（n = 71）和第2组（n = 13）病例在性别、屈光、术前远距离斜视度、屈光参差和术后斜视度、双眼视、手术成功率或随访时间方面无显著差异（p>0.05）。第2组病例的弱视率、近距离斜视度和手术量更高（p<0.05）。第3组（n = 64）和第4组（n = 20）受试者在性别、手术年龄、屈光、弱视、屈光参差、术前斜视度、对称和不对称手术次数、手术量或术后双眼视方面未检测到显著差异（p>0.05）。第3组病例的平均术后随访时间为15.41±19.93个月（范围6 - 98个月），第4组病例为40.45±40.06个月（范围6 - 143个月）（p = 0.000）。对称组和不对称组成功病例每1毫米手术矫正的斜视度差异无统计学意义（p>0.05）。
根据临床特征，婴儿型内斜视患者可选择对称或不对称手术。每个临床科室有必要回顾自身的剂量反应结果。
