Bryselbout Sophie, Promelle Veronique, Pracca Florent, Milazzo Solange
1 Department of Ophthalmology, University Hospital of Amiens-Picardie, EVICR.net APOCHU 86, Amiens, France.
2 University of Picardie Jules Verne, CHU Amiens-Picardie, Amiens, France.
Eur J Ophthalmol. 2019 Jan;29(1):33-37. doi: 10.1177/1120672118769787. Epub 2018 Apr 18.
: Consecutive exotropia is one of the complications of esotropia surgery. Its prevalence is estimated at 4%-27%. The aim of this study was to identify the risk factors for consecutive exotropia in the aftermath of surgical treatment of esotropia.
: Seventy-four patients examined in our strabismus consultation for a consecutive exotropia from January 2010 to June 2016 were retrospectively included. The age of onset of esotropia, the presence of amblyopia, the age of esotropia surgery and chosen procedure, the refractive errors, the anomalies of ocular motility, the age of onset of the consecutive exotropia and its angle of deviation were reported. Statistical analyses were performed with Student's test and Fisher's exact test.
: Esotropia occurred in 65% of cases before the age of 1 year, was associated with amblyopia in 51%, hyperopia in 55% or anisometropia in 31%. Surgery was performed before the age of 6 years for 55% of the patients and involved for 52% the both medial recti. The angle of deviation of consecutive exotropia was ≤20 prism dioptres (PD) in 39%, 21-40 PD in 39% and ≥ 40 PD in 22%, related to amblyopia (p = 0.028), and to high hypermetropia (p = 0.05).
: Amblyopia and hyperopia were the most important risk factors of consecutive exotropia in our series. Early onset esotropia, stereopsis abnormalities, anisometropia, oblique dysfunction, convergence insufficiency appeared but did not reach statistical significance.
: Amblyopia is a major risk factor that should be taken into consideration during surgery of an esotropia.
连续性外斜视是内斜视手术的并发症之一。其发生率估计为4% - 27%。本研究的目的是确定内斜视手术治疗后发生连续性外斜视的危险因素。
回顾性纳入2010年1月至2016年6月在我们斜视门诊检查的74例连续性外斜视患者。报告了内斜视的发病年龄、弱视的存在情况、内斜视手术的年龄及所选术式、屈光不正、眼球运动异常、连续性外斜视的发病年龄及其偏斜角度。采用学生检验和Fisher精确检验进行统计分析。
65%的病例内斜视发生在1岁之前，51%与弱视有关，55%与远视有关，31%与屈光参差有关。55%的患者在6岁之前接受手术，52%的手术涉及双侧内直肌。连续性外斜视的偏斜角度≤20三棱镜度（PD）的占39%，21 - 40 PD的占39%，≥40 PD的占22%，与弱视有关（p = 0.028），与高度远视有关（p = 0.05）。
在我们的系列研究中，弱视和远视是连续性外斜视最重要的危险因素。早期发病的内斜视、立体视异常、屈光参差、斜肌功能障碍、集合不足也有出现，但未达到统计学意义。
弱视是内斜视手术时应考虑的主要危险因素。
