动眼神经麻痹斜视手术的长期疗效

Long term outcomes of strabismus surgery for third nerve palsy.

作者信息

Merino Pilar, Gutierrez Carlota, de Liaño Pilar Gómez, Srur Marcela

机构信息

Hospital General Universitario Gregorio Marañón, Madrid, Spain; Ocular Motility Section, Department of Ophthalmology, Hospital Gregorio Marañón, Madrid, Spain.

出版信息

J Optom. 2019 Jul-Sep;12(3):186-191. doi: 10.1016/j.optom.2018.10.004. Epub 2019 Jan 4.

DOI:10.1016/j.optom.2018.10.004

PMID:30600170

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6612019/

Abstract

PURPOSE

To report long-term outcomes of strabismus surgery for treatment of third nerve palsy.

METHODS

We performed a 15-year retrospective study of patients who had undergone surgery. We analyzed preoperative mean deviation (at 6 months, 1 year after surgery, and at the end of follow-up), type of surgery, and factors predicting outcomes. A final deviation <10 prism diopters (pd) was considered a good esthetic outcome, and no diplopia in the primary position at the end of follow-up was considered a good functional outcome.

RESULTS

Surgery was performed in 31 cases. Mean age was 36.27 years (women, 51.6%). Total and complete third nerve palsy was recorded in 22.6% and acquired palsy in 80.6%. Mean preoperative horizontal deviation (HD) in primary position was 40.24pd (near) and 44.29 (distance) and 14.33pd in vertical deviation (VD). Mean final HD was 8.94pd (near) and 11.35pd (distance), and mean final VD was 6.13. One surgery was performed in 68.9%. A favorable esthetic outcome was obtained in 64.5% and a successful functional outcome in 72.2%. Statistically significant differences were found between near HD (p=0.019) and distance HD (p=0.035) at 1 year compared with the end of follow-up and between VD at 6 months and 1 year after surgery (p=0.03). Mean follow-up was 6.05 years. No specific factors predicted a successful outcome.

CONCLUSIONS

Esthetic and functional results were similar. No predictors of successful outcome were identified. HD was better 1 year after surgery, and VD improved during follow-up.

摘要

目的

报告斜视手术治疗动眼神经麻痹的长期疗效。

方法

我们对接受手术的患者进行了一项为期15年的回顾性研究。我们分析了术前平均斜视度（术后6个月、1年及随访结束时）、手术类型以及预测疗效的因素。最终斜视度<10棱镜度（pd）被视为良好的美学效果，随访结束时第一眼位无复视被视为良好的功能效果。

结果

共31例患者接受了手术。平均年龄为36.27岁（女性占51.6%）。完全性和不完全性动眼神经麻痹分别占22.6%和80.6%。第一眼位术前平均水平斜视度（HD）近视为40.24pd，远视为44.29pd，垂直斜视度（VD）为14.33pd。最终平均HD近视为8.94pd，远视为11.35pd，最终平均VD为6.1（此处原文可能有误，应为6.13）。68.9%的患者接受了一次手术。64.5%的患者获得了良好的美学效果，72.2%的患者获得了成功的功能效果。与随访结束时相比，术后1年的近视HD（p=0.019）和远视HD（p=0.035）以及术后6个月和1年的VD（p=0.03）存在统计学显著差异。平均随访时间为6.05年。未发现预测成功疗效的特定因素。