Kumari Namita, Amitava Abadan Khan, Ashraf Mohammad, Grover Shivani, Khan Ashiya, Sonwani Prabha
Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India.
Oman J Ophthalmol. 2017 May-Aug;10(2):76-80. doi: 10.4103/ojo.OJO_133_2016.
Surgery for horizontal strabismus reportedly has a success rate of 60%-80%. However, which preoperative factors are predictive of this success is not clear.
To identify prognostic factors those are predictive of successful outcome in horizontal strabismus surgery.
Observational analytical study using multiple logistic regression (MLR).
We assessed the medical records of patients who had undergone first-time horizontal muscle strabismus surgery between 2002 and 2013, where complete follow-up data were available for ≥6 weeks, and also, we collected data prospectively on patients operated between January 2014 and September 2015. Successful outcome was defined as a postoperative angle of deviation within 10 prism diopter of orthophoria at ≥6 weeks postoperatively. Independent variables considered were age at onset, age at surgery, duration, gender, deviation - type and amount, logMAR visual acuity (VA) - mean and of the poorer eye, mean refractive error, amount of anisometropia, and presence of dense amblyopia. Only those with < 0.2 on univariate analyses (UAs) were included in the MLR, with significance set at ≤ 0.05.
UA (Chi-square for categorical variables and -tests for continuous variables), followed by logistic regression analysis.
Of 113 patients, on UA, type of deviation ( = 0.01), age at surgery ( = 0.16), absence of dense amblyopia ( = 0.002), and logMAR VA of the poorer eye ( = 0.005) qualified for the inclusion in MLR. On MLR, esotropia (ET) (odds ratio [OR]: 4.46) and absence of dense amblyopia (OR: 5.90) were associated with success.
With an overall success rate of 83%, ET and absence of dense amblyopia were significantly predictive of surgical success.
据报道，水平斜视手术的成功率为60%-80%。然而，哪些术前因素可预测手术成功尚不清楚。
确定可预测水平斜视手术成功结果的预后因素。
采用多元逻辑回归（MLR）的观察性分析研究。
我们评估了2002年至2013年间首次接受水平肌斜视手术且有≥6周完整随访数据的患者的病历，并且前瞻性收集了2014年1月至2015年9月间接受手术患者的数据。成功结果定义为术后≥6周时斜视度在正位视10棱镜度以内。考虑的自变量包括发病年龄、手术年龄、病程、性别、斜视类型和度数、对数最小分辨角视力（logMAR VA）-双眼平均值及较差眼的数值、平均屈光不正、屈光参差量以及重度弱视的存在情况。单因素分析（UA）中P<0.2的因素才纳入MLR，显著性设定为P≤0.05。
UA（分类变量采用卡方检验，连续变量采用t检验），随后进行逻辑回归分析。
113例患者中，经UA分析，斜视类型（P=0.01）、手术年龄（P = 0.16）、无重度弱视（P = 0.002）以及较差眼的logMAR VA（P = 0.005）符合纳入MLR的标准。经MLR分析，内斜视（ET）（比值比[OR]：4.46）和无重度弱视（OR：5.90）与手术成功相关。
总体成功率为83%，ET和无重度弱视是手术成功的显著预测因素。
