Chen Yun-Wen, Lin Sue-Ann, Lin Pei-Wen, Huang Hsiu-Mei
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd, Niaosong Dist, Kaohsiung, 833, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Int Ophthalmol. 2019 Jul;39(7):1427-1436. doi: 10.1007/s10792-018-0956-5. Epub 2018 Jun 19.
To determine the factors that affect ocular alignment and binocular sensory functions after strabismus surgery and compare surgical outcomes between manifest exotropia (XT) and esotropia (ET).
In a retrospective study, 41 XT and 17 ET patients who had undergone strabismus surgery were recruited. Information on type and duration of strabismus, age at onset of deviation and surgery, pre- and postoperative strabismus deviation angles, and binocular sensory functions including stereoacuity and macular fusion capacity was recorded.
In all patients, the ocular alignment and binocular sensory functions improved with time following surgery. Residue strabismus deviation angles (≦ 10 prism diopters) at postoperative 1 month determined the final successful ocular alignment. In patients with final excellent binocular sensory functions, XT group restored macular fusion capacity and stereoacuity at postoperative 1 month, but ET group regained macular fusion capacity at postoperative 1 month and then restored stereoacuity at postoperative 3 months. Though XT patients showed better pre- and postoperative stereoacuity than ET patients, patients with successful ocular alignment had an odd of 4.5 in XT group and 22.5 in ET group to achieve excellent and fair binocular sensory functions.
Surgical correction of strabismus could improve ocular alignment and binocular sensory functions in patients with manifest strabismus, regardless of onset age, strabismus duration, or type. Postoperative 1-month status may help to predict the final motor and sensory outcomes. ET patients would benefit more final successful ocular alignment and excellent binocular sensory functions from early surgery and maintaining postoperative small deviation angle than XT patients.
确定斜视手术后影响眼位矫正及双眼感觉功能的因素，并比较显斜视（外斜视，XT）和内斜视（内斜视，ET）的手术效果。
在一项回顾性研究中，招募了41例接受斜视手术的XT患者和17例ET患者。记录斜视类型、持续时间、斜视开始及手术时的年龄、术前和术后斜视偏斜角度，以及包括立体视锐度和黄斑融合能力在内的双眼感觉功能。
所有患者术后眼位矫正及双眼感觉功能均随时间改善。术后1个月时残余斜视偏斜角度（≤10棱镜度）决定最终眼位矫正是否成功。最终双眼感觉功能良好的患者中，XT组术后1个月恢复黄斑融合能力和立体视锐度，而ET组术后1个月恢复黄斑融合能力，术后3个月恢复立体视锐度。虽然XT患者术前和术后的立体视锐度均优于ET患者，但眼位矫正成功的患者中，XT组实现良好和中等双眼感觉功能的几率为4.5，ET组为22.5。
斜视手术矫正可改善显斜视患者的眼位矫正及双眼感觉功能，与发病年龄、斜视持续时间或类型无关。术后1个月的情况有助于预测最终的运动和感觉结果。与XT患者相比，ET患者早期手术及术后维持较小偏斜角度，更有利于最终成功的眼位矫正及良好的双眼感觉功能。
