Wang Xi, Chen Xiaohang, Liu Longqian
Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.
Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China.
Ophthalmic Res. 2019;61(2):120-124. doi: 10.1159/000494560. Epub 2018 Dec 6.
To evaluate the efficacy of bilateral lateral rectus muscle recession (BLR) to treat recurrent exotropia after bilateral medial rectus muscle resection (BMR).
Twenty-four patients who underwent BLR for recurrent exotropia and were followed up for more than 6 months were included in this retrospective study. All of them had prior BMR. The angle of deviation, success rates, near stereopsis, and surgical effect of BLR were evaluated. Surgical success was defined as postoperative deviations ≤10 prism diopters (PD).
The overall mean follow-up time after reoperation for patients was 24.13 ± 15.01 months (range 6-60 months). The mean angle of deviation at distance was significantly reduced from -37.75 ± 14.93 PD to +1.50 ± 6.43 PD (p < 0.001). Twenty-two (91.6%) of 24 patients had successful outcomes, 1 (4.2%) had overcorrection, and 1 (4.2%) had undercorrection at the last follow-up. Improved stereopsis after reoperation was observed in 78.3% (18/23) of the patients. The mean surgical effect was 2.78 ± 0.71 PD/mm.
Based on our results, BLR could be an effective and safe method for treating recurrent exotropia after a moderate to large amount of BMR.
评估双侧外直肌后徙术（BLR）治疗双侧内直肌切除术（BMR）后复发性外斜视的疗效。
本回顾性研究纳入了24例行BLR治疗复发性外斜视且随访时间超过6个月的患者。他们均曾接受过BMR。评估了BLR的斜视度、成功率、近立体视和手术效果。手术成功定义为术后斜视度≤10棱镜度（PD）。
患者再次手术后的总体平均随访时间为24.13±15.01个月（范围6 - 60个月）。远距离平均斜视度从-37.75±14.93 PD显著降低至+1.50±6.43 PD（p < 0.001）。24例患者中有22例（91.6%）获得成功，1例（4.2%）出现过矫，1例（4.2%）出现欠矫。78.3%（18/23）的患者再次手术后立体视得到改善。平均手术效果为2.78±0.71 PD/mm。
基于我们的结果，BLR可能是治疗中度至大量BMR后复发性外斜视的一种有效且安全的方法。
