Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta.
Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta..
Can J Ophthalmol. 2019 Feb;54(1):94-97. doi: 10.1016/j.jcjo.2018.04.007. Epub 2018 May 18.
To report the reoperation rate in a large group of pediatric and adult strabismus patients over a 21-year period in Northern Alberta, Canada.
A retrospective review of 6177 strabismus surgeries from July 1995 to June 2015 on 5125 pediatric and adult patients was conducted to determine the reoperation rate at a single major referral centre. A set of guidelines was implemented in November 2014 recommending delaying reintervention for at least 12 weeks from the initial surgery, with specific exceptions.
The historical strabismus reoperation rate over a 21-year period was 15.7%. Of those surgeries requiring reoperation, 77.7% required only 1 reoperation, 17.1% required 2 reoperations, 3.1% required 3 reoperations, and 2.1% required 4 or more reoperations. The mean time between surgeries for patients undergoing reoperation was 2.3 years and the median time was 1.0 years.
Our study provides insight into the strabismus reoperation rate and the number of subsequent surgeries performed for patients over a 21-year period. Although preoperative ocular alignment, comorbidities, and the status of the operative eye modify the probability of reoperation, our results from a large cohort of patients provide an impression of the rate of reoperation and may be of benefit in the preoperative counseling of patients. Furthermore, we highlight the scarcity of guidelines for the appropriate timing of reoperation. The implementation of specific guidelines may encourage future investigation into trends in reoperation over time and promote ways to avoid unnecessary surgeries, lower health care costs to stakeholders, and ultimately improve patient care.
报告在加拿大阿尔伯塔省北部一家主要转诊中心的 21 年间，大量儿科和成人斜视患者的再次手术率。
对 1995 年 7 月至 2015 年 6 月期间 5125 名儿科和成人斜视患者的 6177 次斜视手术进行回顾性分析，以确定单一主要转诊中心的再次手术率。2014 年 11 月实施了一套指南，建议至少在初次手术后 12 周后再进行干预，除非有特殊情况。
21 年间的斜视再次手术历史率为 15.7%。在需要再次手术的手术中，77.7%仅需 1 次手术，17.1%需要 2 次手术，3.1%需要 3 次手术，2.1%需要 4 次或更多次手术。再次手术患者的两次手术之间的平均时间为 2.3 年，中位数时间为 1.0 年。
本研究提供了在 21 年间斜视再次手术率和为患者进行的后续手术数量的见解。尽管术前眼球对准、合并症和手术眼的状态会改变再次手术的概率，但我们从大量患者中得出的结果提供了再次手术的概率印象，可能有助于患者的术前咨询。此外，我们强调了缺乏适当再次手术时机的指南。具体指南的实施可能会鼓励未来对随时间推移的再次手术趋势进行调查，并促进避免不必要手术的方法，降低利益相关者的医疗保健成本，并最终改善患者护理。
