非集合不足型内斜视与集合不足型内斜视手术剂量反应的比较。
Comparison of surgical dose response between divergence insufficiency esotropia and non-accommodative esotropia without divergence insufficiency.
机构信息
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
PLoS One. 2019 Jul 24;14(7):e0220201. doi: 10.1371/journal.pone.0220201. eCollection 2019.
BACKGROUND
The study compared the surgical dose-response relationship for divergence insufficiency esotropia (DIE) and non-accommodative esotropia without divergence insufficiency (non-DIE).
METHODS
We carried out a retrospective review of a group of patients with DIE and non-DIE who underwent recession surgery of the medial rectus muscle in both eyes. Linear regression analysis compared surgical dose-response between the two groups.
RESULTS
In the 15 patients with DIE, the mean preoperative ocular deviation at distant fixation was 25 prism diopters (PD), compared with 3 PD postoperatively. In the 38 non-DIE patients, the mean preoperative ocular deviation was 28 PD, compared with 3 PD postoperatively. The average surgical dose-response was 1.56 PD/mm in the DIE group and 2.91 PD/mm in the non-DIE group (p < 0.001).
CONCLUSIONS
Surgical dose-response was significantly lower in DIE patients than in non-DIE patients. Augmented MR recession surgery could be regarded as an effective treatment option for patients with DIE. Further study with a larger sample and long-term follow-up is needed to seek the proper extent of surgery in these patients.
背景
本研究比较了伴有和不伴有集合不足的内斜视（DIE 和非集合不足性内斜视，non-DIE）的手术剂量反应关系。
方法
我们对一组接受双眼内直肌后退术的 DIE 和 non-DIE 患者进行了回顾性研究。线性回归分析比较了两组之间的手术剂量反应。
结果
在 15 例 DIE 患者中，术前远距固视时眼位偏斜的平均值为 25 棱镜度（PD），术后为 3 PD。在 38 例 non-DIE 患者中，术前眼位偏斜的平均值为 28 PD，术后为 3 PD。DIE 组的平均手术剂量反应为 1.56 PD/mm，non-DIE 组为 2.91 PD/mm（p < 0.001）。
结论
DIE 患者的手术剂量反应明显低于 non-DIE 患者。增强型 MR 内直肌后退术可作为 DIE 患者的有效治疗选择。需要进一步进行更大样本量和长期随访的研究，以确定这些患者的适当手术范围。
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