Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
Department of Ophthalmology, Gangnam Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2020 Feb;258(2):445-450. doi: 10.1007/s00417-019-04510-z. Epub 2019 Nov 19.
To describe characteristics of recurrent intermittent exotropia after bilateral lateral rectus (BLR) recession, and identify factors associated with poor outcome after unilateral medial rectus (MR) resection for recurrent intermittent exotropia.
We retrospectively reviewed 124 patients who have undergone unilateral MR resection for recurrent intermittent exotropia after BLR recession. Patients were followed for at least 2 years after MR resection. Clinical characteristics and risk factors associated with poor outcome after unilateral MR resection were evaluated. Successful outcome was defined as distant deviation within the range of 4 prism diopters (PD) esotropia and 10 PD exotropia at last visit after MR resection.
Among 124 patients, 50 patients (41.1%) were male, and the mean age at the time of MR resection was 9.5 ± 3.1 years. The average follow-up period after MR resection was 43.8 ± 23.7 months. Forty-seven patients (37.9%) were classified to have poor outcome at last visit, and 29 patients (23.4%) underwent third operation. None of the patients was overcorrected after MR resection. Multiple logistic regression analyses showed that distant deviation at post-operative 3 months and male gender were associated with poor outcome (OR 1.49; 95% CI 1.27-1.73; P < 0.001, and OR 5.19; 95% CI 1.42-18.98; P = 0.013, respectively).
Ocular deviation at 3 months after unilateral MR resection for recurrent intermittent exotropia may play a valuable role in anticipating poor outcome. Patients whose exotropia exceeded 9 PD at distance at 3 months' follow-up tended to recur while those whose exotropia remained below 9 PD at distance showed a stable disease course.
描述双侧外直肌后退（BLR）后复发性间歇性外斜视（XTT）的特征，并确定单侧内直肌（MR）切除治疗复发性间歇性外斜视后不良结果的相关因素。
我们回顾性分析了 124 例接受单侧 MR 切除治疗 BLR 后退后复发性间歇性外斜视的患者。患者在 MR 切除后至少随访 2 年。评估了与单侧 MR 切除后不良结果相关的临床特征和危险因素。成功的结果定义为 MR 切除后最后一次就诊时远距斜视度在 4 棱镜度（PD）内斜视和 10 PD 外斜视范围内。
在 124 例患者中，50 例（41.1%）为男性，MR 切除时的平均年龄为 9.5 ± 3.1 岁。MR 切除后平均随访时间为 43.8 ± 23.7 个月。47 例（37.9%）患者在最后一次就诊时被归类为不良结果，29 例（23.4%）患者接受了第三次手术。MR 切除后无过矫。多因素逻辑回归分析显示，术后 3 个月的远距偏斜和男性与不良结果相关（OR 1.49；95%CI 1.27-1.73；P<0.001，和 OR 5.19；95%CI 1.42-18.98；P=0.013，分别）。
单侧 MR 切除治疗复发性间歇性外斜视后 3 个月的眼位偏斜可能对预测不良结果有重要作用。那些在 3 个月的随访时远距斜视超过 9 PD 的患者容易复发，而那些远距斜视保持在 9 PD 以下的患者则显示出稳定的病程。
