Chatzistefanou Klio I, Brouzas Dimitrios, Droutsas Konstantinos D, Koutsandrea Chryssanthi, Chimonidou Eleutheria
a Strabismus Service, First Department of Ophthalmology , National and Kapodistrian University of Athens Medical School , Athens , Greece.
Semin Ophthalmol. 2018;33(4):498-505. doi: 10.1080/08820538.2017.1312465. Epub 2017 May 10.
To outline the short- and long-term motor outcomes of unilateral medial rectus muscle recession and lateral rectus muscle resection for the correction of moderate angle infantile esotropia.
A retrospective study of 109 consecutive patients with moderate angle infantile esotropia treated with graded unilateral recession-resection surgery. Criteria for successful motor outcome included alignment ±10Δ from orthophoria. Outcome evaluation was a comparison of successful alignment versus an overcorrection or undercorrection at eight weeks postoperatively as well as on the final follow-up examination.
The mean preoperative deviation was 35.5 prism diopters (Δ) and mean follow-up time was 4.9 years. At the eight-week postoperative examination, 99 patients (89.9%) were successfully aligned, as opposed to 75 of 95 patients (78.9%) at the final postoperative visit (P=0.041). There was no statistically significant difference between the rate of early versus late undercorrections (7.3% versus 12.5%, P=0.267) or overcorrections (2.7% versus 8.3%, P=0.125). Ten patients had an esotropic drift over time and 10 patients had an exotropic drift. Recurrent esotropia was associated with high hyperopia and presumed infantile esotropia diagnostic entity. The Kaplan-Meier estimate of survivorship of a successful motor outcome was 75.5% at five years and 71% at 15 years postoperatively. The mean response to surgery was 2.9Δ per mm of muscle recessed and resected and was positively related to the preoperative angle of deviation (R=0.615).
The unilateral recession-resection procedure for the correction of infantile esotropia is shown to be associated with a favorable survival of motor outcomes and a relatively balanced rate of undercorrections versus overcorrections tending to be maintained through the follow-up period.
概述采用单侧内直肌后徙术和外直肌切除术矫正中度角型婴儿型内斜视的短期和长期运动结局。
对109例连续接受分级单侧后徙-切除术治疗的中度角型婴儿型内斜视患者进行回顾性研究。运动结局成功的标准包括与正位眼相差±10三棱镜度（Δ）的眼位矫正。结局评估是比较术后8周时成功矫正眼位与过矫或欠矫情况，以及末次随访检查时的情况。
术前平均斜视度为35.5棱镜度（Δ），平均随访时间为4.9年。术后8周检查时，99例患者（89.9%）眼位成功矫正，而术后末次随访时95例患者中有75例（78.9%）成功矫正（P = 0.041）。早期与晚期欠矫率（7.3%对12.5%，P = 0.267）或过矫率（2.7%对8.3%，P = 0.125）之间无统计学显著差异。10例患者随时间出现内斜视漂移，10例患者出现外斜视漂移。复发性内斜视与高度远视及推测的婴儿型内斜视诊断实体相关。术后5年成功运动结局的Kaplan-Meier生存估计值为75.5%，术后15年为71%。手术的平均反应为每毫米肌肉后徙和切除2.9Δ，且与术前斜视角度呈正相关（R = 0.615）。
采用单侧后徙-切除术矫正婴儿型内斜视显示出与良好的运动结局生存率相关，并且在随访期间欠矫与过矫率相对平衡。
