Lee Haeng Jin, Kim Jeong-Ah, Kim Seong-Joon, Yu Young Suk
Department of Ophthalmology, Seoul National University College of Medicine, Seoul 110-744, South Korea.
Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul 110-744, South Korea.
Int J Ophthalmol. 2018 Dec 18;11(12):1963-1967. doi: 10.18240/ijo.2018.12.15. eCollection 2018.
To evaluate the relation between preoperative hyperopia and surgical outcomes of infantile esotropia in patients younger than 24 months of age.
Medical records of patients who underwent bilateral medial rectus muscle recession for infantile esotropia between November 1, 2002 and December 1, 2011 were retrospectively reviewed. Patients were divided into two groups according to the degree of preoperative hyperopia. Group I had less than +3.0 diopter (D) of hyperopia and group II had between +3.0 and +5.0 D of hyperopia. Postoperative alignments were evaluated 1wk, 3, 6mo, and 1y after surgery. Following the 1-year postoperative visit, patients were monitored yearly. Relationships between preoperative factors including hyperopia and postoperative outcomes were evaluated.
Forty-six patients were included, with 33 patients in group I and 13 patients in group II. The preoperative mean refractive error was +0.88 D in group I and +3.45 D in group II. Surgical outcomes were not significantly different between groups at any postoperative time point examined. Cumulative probability of surgical success, prevalence of inferior oblique overaction, dissociated vertical deviation, and re-operation rate were not significantly different between groups.
Preoperative moderate hyperopia (less than +5.0 D) did not affect the surgical outcome of infantile esotropia. Therefore, the surgical correction of esotropia should be considered when the angle of esodeviation is unchanged following hyperopia correction, even in children with moderate hyperopia.
评估24个月以下婴幼儿内斜视患者术前远视与手术效果之间的关系。
回顾性分析2002年11月1日至2011年12月1日期间因婴幼儿内斜视接受双侧内直肌后徙术患者的病历。根据术前远视程度将患者分为两组。第一组远视度数小于+3.0屈光度(D),第二组远视度数在+3.0至+5.0 D之间。术后1周、3个月、6个月和1年评估眼位矫正情况。术后1年随访后,每年对患者进行监测。评估包括远视在内的术前因素与术后效果之间的关系。
共纳入46例患者,其中第一组33例,第二组13例。第一组术前平均屈光不正为+0.88 D,第二组为+3.45 D。在任何术后检查时间点,两组的手术效果均无显著差异。两组之间手术成功的累积概率、下斜肌亢进的发生率、分离性垂直偏斜和再次手术率均无显著差异。
术前中度远视(小于+5.0 D)不影响婴幼儿内斜视的手术效果。因此,即使是中度远视儿童,在矫正远视后内斜视角度无变化时,也应考虑手术矫正内斜视。