Kim Jung Yup, Lee Soo Jung
Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeundae-Ro, Haeundae-Gu, Busan, 612-896, South Korea.
BMC Ophthalmol. 2017 Dec 29;17(1):266. doi: 10.1186/s12886-017-0658-1.
To evaluate the efficacy of unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia within 25 prism diopters (PD) occurring after bilateral lateral rectus muscle recession for intermittent exotropia.
Medical records of 11 patients who underwent unilateral lateral rectus muscle advancement for consecutive esotropia from 2011 to 2014 and who were observed for at least 6 months after surgery were retrospectively reviewed. The change in angle of deviation from before to after consecutive esotropia surgery, as well as the success rate and surgical effect, were evaluated.
Preoperative esodeviation was -19.6 ± 4.7 PD [median - 20.0 PD, interquartile range (IQR) 9.0] at distance and -16.5 ± 7.4 PD [median - 18.0 PD, IQR 17.0] at near. The mean surgical amount of unilateral lateral rectus muscle advancement surgeries, based on one-fourth of the angle of consecutive esotropia, was 4.8 ± 1.1 mm [median 5.0 mm, IQR 2.0]. Of the 11 patients, 10 (91%) recovered to orthotropia or exodeviation within 8 PD. The surgical effects of unilateral lateral rectus muscle advancement were 3.3 ± 0.7 PD/mm [median 3.6 PD/mm, IQR 1.0] after 1 day, 3.7 ± 0.6 PD/mm [median 3.8 PD/mm, IQR 1.0] after 1 week, and 3.8 ± 0.7 PD/mm [median 3.8 PD/mm, IQR 1.5] after 6 months.
Unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia within 25 PD was successful in all 11 patients. The surgical effect was significantly greater in unilateral lateral rectus muscle advancement than in primary lateral rectus muscle recession. Reduction in the amount of surgery should be considered carefully in unilateral lateral rectus muscle advancement for consecutive esotropia.
评估基于间歇性外斜视双侧外直肌后徙术后25棱镜度（PD）以内连续性内斜视角度的四分之一进行单侧外直肌前徙手术的疗效。
回顾性分析2011年至2014年因连续性内斜视接受单侧外直肌前徙手术且术后至少观察6个月的11例患者的病历。评估连续性内斜视手术前后斜视角度的变化、成功率及手术效果。
术前远距离内斜度为-19.6±4.7 PD[中位数-20.0 PD，四分位数间距（IQR）9.0]，近距离为-16.5±7.4 PD[中位数-18.0 PD，IQR 17.0]。基于连续性内斜视角度的四分之一进行的单侧外直肌前徙手术的平均手术量为4.8±1.1 mm[中位数5.0 mm，IQR 2.0]。11例患者中，10例（91%）在8 PD以内恢复为正位或外斜。单侧外直肌前徙术后1天的手术效果为3.3±0.7 PD/mm[中位数3.6 PD/mm，IQR 1.0]，1周后为3.7±0.6 PD/mm[中位数3.8 PD/mm，IQR 1.0]，6个月后为3.8±0.7 PD/mm[中位数3.8 PD/mm，IQR 1.5]。
基于25 PD以内连续性内斜视角度的四分之一进行的单侧外直肌前徙手术在所有11例患者中均获成功。单侧外直肌前徙的手术效果明显优于原发性外直肌后徙。对于连续性内斜视的单侧外直肌前徙手术，应谨慎考虑减少手术量。
