Na Kun-Hoo, Cho Yoonae A, Kim Seung-Hyun
J Pediatr Ophthalmol Strabismus. 2018 Mar 1;55(2):93-99. doi: 10.3928/01913913-20170703-15. Epub 2017 Nov 14.
To investigate the development pattern and related factors of postoperative re-drift in infantile esotropia.
A total of 112 patients with infantile esotropia who underwent surgery before 3 years of age were included. Surgical outcomes were divided into (1) consecutive exotropia: more than 8 prism diopters (PD) of exodeviation; (2) recurrent esotropia: more than 8 PD of esodeviation; and (3) monofixation syndrome: maintenance of deviations within 8 PD. The occurrence rate, time of onset, and associated factors of the re-drift were evaluated.
At a mean follow-up of 9.5 years, consecutive exotropia developed in 37 patients (33.0%) and recurrent esotropia in 43 patients (38.4%). Whereas 76.7% of total recurrent esotropia cases were identified within postoperative 1 year, consecutive exotropia occurred constantly over 10 years postoperatively. The mean time to consecutive exotropia development from surgery was 78.6 months, greater than that of recurrent esotropia development (8.9 months) (P < 0.001). In multinomial logistic regression using monofixation syndrome as the reference category, fixation preference before surgery (odds ratio [OR]: 6.64, 95% confidence interval [CI]: 2.07 to 21.32) and the rate of myopic progression (OR: 15.07 per -1.00 D/year, 95% CI: 1.23 to 184.86) were associated with consecutive exotropia, whereas increase in the angle of esodeviation on postoperative day 1 (OR: 1.15, 95% CI: 1.04 to 1.26) was correlated with recurrent esotropia.
This study demonstrates a difference between the development pattern of exotropic and esotropic drift after infantile esotropia surgery. Detailed preoperative assessment and close postoperative observation of deviations and refractive status will help to determine surgical outcomes of infantile esotropia. [J Pediatr Ophthalmol Strabismus. 2018;55(2):128-134.].
探讨婴儿型内斜视术后再漂移的发展模式及相关因素。
纳入112例3岁前接受手术的婴儿型内斜视患者。手术结果分为：（1）连续性外斜视：外斜度超过8棱镜度（PD）；（2）复发性内斜视：内斜度超过8 PD；（3）单眼注视综合征：斜视度维持在8 PD以内。评估再漂移的发生率、发病时间及相关因素。
平均随访9.5年，37例（33.0%）发生连续性外斜视，43例（38.4%）发生复发性内斜视。复发性内斜视病例中76.7%在术后1年内出现，而连续性外斜视在术后10年内持续发生。手术至连续性外斜视发生的平均时间为78.6个月，长于复发性内斜视发生的平均时间（8.9个月）（P < 0.001）。以单眼注视综合征为参照类别进行多项逻辑回归分析，术前注视偏好（比值比[OR]：6.64，95%置信区间[CI]：2.07至21.32）和近视进展率（OR：每-1.00 D/年为15.07，95% CI：1.23至184.86）与连续性外斜视相关，而术后第1天内斜度增加（OR：1.15，95% CI：1.04至1.26）与复发性内斜视相关。
本研究表明婴儿型内斜视手术后外斜视和内斜视漂移的发展模式存在差异。详细的术前评估以及术后对斜视度和屈光状态的密切观察将有助于确定婴儿型内斜视的手术效果。[《小儿眼科与斜视杂志》。2018；55(2)：128 - 134。]
