Ghali Manar A
Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Clin Ophthalmol. 2017 Oct 17;11:1877-1881. doi: 10.2147/OPTH.S143773. eCollection 2017.
To compare bimedial rectus muscle recession (BMRR; 7-8 mm) and bimedial rectus muscle elongation (BMRE; 6.5-9 mm) for the surgical treatment of large-angle infantile esotropia (ET; ≥70 prism diopters [PD]).
Twenty-four patients with large-angle infantile ET were divided into 2 groups; group A (n=12) underwent BMRR and group B (n=12) underwent BMRE. All patients received surgery under general anesthesia and were followed for at least 24 months after surgery. The mean dose-response effect at 24 months was calculated for each patient.
The mean preoperative angle of deviation was 79.16±7.64 PD (range, 70-90) in group A and 85.83±9.25 PD (range, 70-100) in group B. The duration of surgery was 55% shorter in group A compared with group B. There were no cases of over-correction, but there were 6 cases of under-correction in group A (50%) and 2 cases of under-correction in group B (16.7%). The mean dose-response effect was 4.42±0.19 PD/mm in group A and 5.45±0.39 PD/mm in group B.
BMRE is more effective than BMRR for the surgical treatment of large-angle infantile ET despite a higher level of technical difficulty.
比较双侧内直肌后徙术（BMRR；7 - 8毫米）和双侧内直肌延长术（BMRE；6.5 - 9毫米）在治疗大角度婴儿型内斜视（ET；≥70三棱镜度[PD]）中的效果。
24例大角度婴儿型ET患者分为两组；A组（n = 12）接受BMRR，B组（n = 12）接受BMRE。所有患者均在全身麻醉下接受手术，并在术后至少随访24个月。计算每位患者术后24个月的平均剂量反应效应。
A组术前平均斜视度为79.16±7.64 PD（范围70 - 90），B组为85.83±9.25 PD（范围70 - 100）。A组手术时间比B组短55%。无过矫病例，但A组有6例欠矫（50%），B组有2例欠矫（16.7%）。A组平均剂量反应效应为4.42±0.19 PD/mm，B组为5.45±0.39 PD/mm。
尽管技术难度较高，但在大角度婴儿型ET的手术治疗中，BMRE比BMRR更有效。
