Shin Kwang Hoon, Kim Iris Naheah, Paik Hae Jung
Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.
Korean J Ophthalmol. 2017 Jun;31(3):268-274. doi: 10.3341/kjo.2015.0168. Epub 2017 May 11.
To investigate the effect of preoperative part-time occlusion therapy on long-term surgical success in early-onset exotropia.
The medical records of patients who underwent surgery for exotropia with onset before the first year of age and who were followed for ≥3 years were reviewed. Patients were divided into two groups according to the degree of compliance with part-time occlusion therapy: the good compliance group (>50% adherence rate) and the poor compliance group (≤50% adherence rate). Surgical success was defined as orthophoria to exodeviation less than 10 prism diopters both at distance and near. The level of postoperative stereopsis was compared between the two study groups among total enrolled patients and among those with constant exotropia.
Of the 51 patients, 26 were assigned to the good compliance group and the remaining 25 patients to the poor compliance group. The surgical success rate was significantly higher in the good compliance group than in the poor compliance group (80.8% vs. 52.0%, p = 0.040). Among 24 constant exotropia patients (12 patients for each group), the success rate was insignificantly higher in the good compliance group than in the poor compliance group (75.0% vs. 58.3%, p = 0.448). The good compliance group had a better level of stereopsis than the poor compliance group (p = 0.045 for all 44 patients, p = 0.020 for 19 patients with constant exotropia).
Preoperative part-time occlusion therapy was useful for improving the surgical outcome of early-onset exotropia and postoperative stereopsis.
探讨术前部分时间遮盖疗法对早发性外斜视长期手术成功率的影响。
回顾了1岁前发病并接受外斜视手术且随访≥3年的患者的病历。根据部分时间遮盖疗法的依从程度将患者分为两组：依从性好的组（依从率>50%）和依从性差的组（依从率≤50%）。手术成功定义为远距离和近距离均为正位或外斜度小于10三棱镜度。比较两组研究对象在所有入组患者以及恒定性外斜视患者中的术后立体视水平。
51例患者中，26例被分配到依从性好的组，其余25例患者被分配到依从性差的组。依从性好的组手术成功率显著高于依从性差的组（80.8%对52.0%，p = 0.040）。在24例恒定性外斜视患者中（每组12例），依从性好的组成功率略高于依从性差的组，但差异无统计学意义（75.0%对58.3%，p = 0.448）。依从性好的组立体视水平优于依从性差的组（所有44例患者p = 0.045，19例恒定性外斜视患者p = 0.020）。
术前部分时间遮盖疗法有助于改善早发性外斜视的手术效果和术后立体视。
