Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Ophthalmol. 2021 Jan;31(1):258-262. doi: 10.1177/1120672119870094. Epub 2019 Aug 14.
To compare lateral rectus advancement with medial rectus recession for patients with consecutive esotropia without abduction limitation.
Forty-three patients who developed consecutive esotropia following bilateral lateral rectus recession for intermittent exotropia were reviewed retrospectively. Twenty-two patients underwent lateral rectus advancement (lateral rectus advancement group) and medial rectus recession was performed in 21 patients (medial rectus recession group). Success rate of the surgery was based on the percentage of postoperative esophoria or exophoria of less than 8 PD, which did not require a third surgery. Mean follow-up after second surgery was 23.5 ± 8.7 months.
Mean consecutive esotropia in the lateral rectus advancement group was 24.8 ± 9.0 PD. Eight patients were orthophoric after second surgery; mean postoperative esophoria and exophoria/tropia was 5.4 ± 3.4 PD and 6.5 ± 5 PD, respectively. Postoperative success rate in this group was 90.9%. Mean consecutive esotropia in the medial rectus recession group was 21 ± 98.4 PD. Three patients were orthophoric after second surgery; mean postoperative esotropia/phoria and exophoria was 9.5 ± 5.0 PD and 5.2 ± 1.3 PD, respectively. Postoperative success rate in this group was 71.4%. Postoperative undercorrection rate of 4.5% in lateral rectus advancement group was significantly less than the similar measure of 28.6% in medial rectus recession group (chi-square, P = 0.03).
Advancement of the previously recessed lateral rectus has improved consecutive esotropia better than medial rectus recession.
比较外侧直肌后徙与内直肌后退术治疗无外展受限的继发型共同性内斜视。
回顾性分析 43 例因双侧外直肌后退术治疗间歇性外斜视后出现继发型共同性内斜视的患者。22 例患者行外侧直肌后徙术（外侧直肌后徙组），21 例行内直肌后退术（内直肌后退组）。手术成功的定义为术后斜视度小于 8 棱镜度的内斜视或外斜视，且无需再次手术。第二次手术后的平均随访时间为 23.5 ± 8.7 个月。
外侧直肌后徙组平均继发型共同性内斜视为 24.8 ± 9.0 PD。8 例患者第二次手术后为正位，平均术后内斜视和外斜视/斜视度分别为 5.4 ± 3.4 PD 和 6.5 ± 5 PD。该组术后成功率为 90.9%。内直肌后退组平均继发型共同性内斜视为 21 ± 98.4 PD。3 例患者第二次手术后为正位，平均术后内斜视和外斜视/斜视度分别为 9.5 ± 5.0 PD 和 5.2 ± 1.3 PD。该组术后成功率为 71.4%。外侧直肌后徙组术后欠矫率为 4.5%，明显低于内直肌后退组的 28.6%（卡方检验，P = 0.03）。
与内直肌后退术相比，先前行后退术的外侧直肌后徙术能更好地改善继发型共同性内斜视。
