Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India.
Pediatric Ophthalmology Services, Binh Dinh Eye Hospital, Quy Nhon City, Vietnam.
Asia Pac J Ophthalmol (Phila). 2019 May-Jun;8(3):218-223. doi: 10.22608/APO.2018415. Epub 2019 May 15.
To evaluate the outcome of bilateral symmetric and asymmetric superior rectus (SR) recessions in patients with bilateral dissociated vertical deviation (DVD) without oblique dysfunction and determine factors that might influence the surgical outcome.
Retrospective study.
All patients who underwent bilateral SR recession for bilateral DVD from January 2012 to December 2016 at an eye hospital in New Delhi, India were included. Indication for surgery was decompensated DVD in 1 or both eyes. Symmetric SR recession was performed for symmetric DVD and asymmetric SR recession was performed for asymmetric DVD of 10 prism diopters (PD) or more. Patients with a minimum follow-up of 6 months were included. Success was defined as absence of manifest DVD in both eyes at the final postoperative visit.
Medical records of 27 patients were analyzed. Their median age at surgery was 8 years [interquartile range (IQR), 6-10 years] and mean follow-up was 16.3 months (range, 6-48 months). Symmetric and asymmetric surgeries were performed in 19 and 8 patients, respectively. The amount of SR recession performed ranged from 5 to 10 mm. The median DVD reduced from 9 PD (IQR, 6-14 PD) to 5 PD (IQR, 3-8 PD) in the right eye ( = 0.015) and 9 PD (IQR, 7-12 PD) to 6 PD (IQR, 3-10 PD) in the left eye ( = 0.016) after surgery. Successful outcome was seen in 63% of patients. There was no difference in successful outcome with respect to age, sex, preoperative horizontal deviation, preoperative vertical deviation, postoperative residual horizontal deviation, surgical technique, asymmetry of SR recession, and magnitude of preoperative DVD. Patients with a preference for fixation were more likely to have a successful outcome.
Bilateral SR recession resulted in a success rate of 63% after single operation for bilateral DVD without oblique dysfunction. We found that the probability of a successful outcome did not depend on age at surgery, sex, preoperative horizontal or vertical deviation, magnitude of preoperative DVD, symmetry of SR recession, or surgical technique.
评估双侧分离性垂直斜视（DVD）无斜肌功能障碍患者双侧对称和非对称上直肌（SR）后退的结果，并确定可能影响手术结果的因素。
回顾性研究。
纳入 2012 年 1 月至 2016 年 12 月在印度新德里一家眼科医院接受双侧 SR 后退治疗的所有双侧 DVD 患者。手术指征为 1 只或 2 只眼代偿失调的 DVD。对对称 DVD 行双侧 SR 后退术，对 10 棱镜度（PD）或以上的非对称 DVD 行非对称 SR 后退术。纳入至少随访 6 个月的患者。术后末次随访时双眼均无明显 DVD 定义为成功。
分析了 27 例患者的病历。手术时的中位年龄为 8 岁[四分位间距（IQR）：6-10 岁]，平均随访时间为 16.3 个月（范围：6-48 个月）。19 例患者行对称手术，8 例患者行非对称手术。SR 后退的量为 5-10mm。右眼 DVD 中位数从 9 PD（IQR：6-14 PD）减少至 5 PD（IQR：3-8 PD）（ = 0.015），左眼从 9 PD（IQR：7-12 PD）减少至 6 PD（IQR：3-10 PD）（ = 0.016）。63%的患者获得成功。年龄、性别、术前水平斜视、术前垂直斜视、术后残余水平斜视、手术技术、SR 后退的非对称性、术前 DVD 大小与手术成功率均无差异。偏好注视的患者更有可能获得成功。
对于无斜肌功能障碍的双侧 DVD，单次双侧 SR 后退手术的成功率为 63%。我们发现，手术成功率与手术时的年龄、性别、术前水平或垂直斜视、术前 DVD 大小、SR 后退的对称性或手术技术无关。
