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复发性外斜视术后早期过度矫正

Early postoperative overcorrection in recurrent exotropia.

作者信息

Ha Suk-Gyu, Kim Seung-Hyun

机构信息

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

出版信息

Can J Ophthalmol. 2017 Dec;52(6):611-615. doi: 10.1016/j.jcjo.2017.05.015. Epub 2017 Aug 4.

Abstract

OBJECTIVE

To investigate the surgical outcome according to the angle of deviation at postoperative day 1 in patients with recurrent exotropia DESIGN: Retrospective case series METHODS: Surgical outcome in patients with recurrent exotropia for at least 1 year was analyzed retrospectively. Patients were divided into 3 subgroups according to the angle of deviation at postoperative day 1: overcorrection group (≥2 prism diopter [PD] of esodeviation), orthotropic group (orthotropia or <5 PD of exodeviation), and undercorrection group (≥5 PD of exodeviation). Success was defined as ≤5 PD of esodeviation or ≤10 PD of exodeviation at the final visit.

RESULTS

One hundred and six patients were included in this study. Age at surgery was 11.8 ± 6.9 years, and preoperative angle of deviation was 22.9 ± 6.3 PD at distant. Patients were followed-up for 24.4 ± 12.8 months. There were 20 (18.9%), 82 (77.4%), and 4 (3.8%) patients in overcorrection, orthotropic, and undercorrection groups at postoperative day 1 (p = 0.001). The surgical success rate at the final visit in the overcorrection group (95%) was higher than that in orthotropic and undercorrection groups (76.8% and 25%, respectively, p = 0.004). In univariate regression analysis, overcorrection at postoperative day 1 was the only reliable factor for long-term success (odds ratio [OR] = 24.101, p = 0.01).

CONCLUSION

Overcorrection at postoperative day 1 is a good surgical predictor of successful outcome in surgery for recurrent exotropia.

摘要

目的

研究复发性外斜视患者术后第1天斜视度偏差角度与手术效果的关系。设计:回顾性病例系列研究。方法:回顾性分析复发性外斜视至少1年患者的手术效果。根据术后第1天的斜视度偏差角度将患者分为3个亚组:过矫组(内斜视≥2棱镜度[PD])、正位组(正位或外斜视<5 PD)和欠矫组(外斜视≥5 PD)。成功定义为末次随访时内斜视≤5 PD或外斜视≤10 PD。

结果

本研究共纳入106例患者。手术年龄为11.8±6.9岁,术前远距离斜视度偏差为22.9±6.3 PD。患者随访24.4±12.8个月。术后第1天过矫组、正位组和欠矫组分别有20例(18.9%)、82例(77.4%)和4例(3.8%)患者(p = 0.001)。过矫组末次随访时的手术成功率(95%)高于正位组和欠矫组(分别为76.8%和25%,p = 0.004)。单因素回归分析显示,术后第1天过矫是长期成功的唯一可靠因素(优势比[OR]=24.101,p = 0.01)。

结论

术后第1天过矫是复发性外斜视手术成功结局的良好手术预测指标。

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