Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea.
Indian J Ophthalmol. 2018 Oct;66(10):1451-1455. doi: 10.4103/ijo.IJO_332_18.
To investigate subsequent strabismus surgeries in patients with no prior medical record and to evaluate discrepancies between surgical findings and preoperative presumptions made based on patient self-reporting and clinical findings.
The medical records of patients who underwent a subsequent strabismus surgery between January 1992 and October 2017 were retrospectively reviewed. Patients with no available medical records were included in analyses. Discrepancies between preoperative presumptions and surgical findings were investigated. Original ocular alignment and previous surgical details were presumed using alternative methods, including patient self-reporting, review old photographs of patient, and checking conjunctival scarring.
Eleven consecutive patients (4 females, 7 males) met the inclusion criteria. The mean age at subsequent surgery was 47.7 years (range, 23-69). Seven patients had exotropia and four patients had esotropia before the subsequent surgery. Seven patients reported originally having exotropia and four patients reported originally having esotropia. However, findings from surgical exploration did not agree with preoperative presumptions from patient self-reporting in 7 of 11 patients (7/11, 63.6%). These discrepancies included errors in the original type of strabismus (7/11, 63.6%), which eye was previously operated on (1/11, 9.1%), and number of prior surgeries (1/11, 9.1%).
When planning a subsequent strabismus surgery in patients with no prior medical record, information obtained from the patient should be used with caution. This includes the original type of strabismus and previous surgical details.
研究既往无病历记录的患者行斜视后续手术的情况,并评估基于患者自述和临床检查结果做出的术前推测与手术发现之间的差异。
回顾性分析 1992 年 1 月至 2017 年 10 月间行斜视后续手术的患者的病历。纳入分析的患者均无既往病历记录。研究人员调查了术前推测与手术发现之间的差异。通过患者自述、查看患者旧照片和检查结膜瘢痕等替代方法,推断原始眼位和既往手术细节。
11 例连续患者(4 名女性,7 名男性)符合纳入标准。后续手术时的平均年龄为 47.7 岁(范围:23-69 岁)。术前斜视类型为外斜视的 7 例,内斜视的 4 例。7 例患者自述原发外斜视,4 例患者自述原发内斜视。然而,7 例患者(7/11,63.6%)的手术探查结果与基于患者自述的术前推测结果不一致,包括斜视原发类型错误(7/11,63.6%)、哪只眼曾手术过(1/11,9.1%)以及既往手术次数(1/11,9.1%)。
当计划无既往病历记录的患者行斜视后续手术时,应谨慎使用从患者处获得的信息,包括斜视原发类型和既往手术细节。