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三级医院斜视手术的当前趋势

Current trends of strabismus surgery in a tertiary hospital.

作者信息

Merino Sanz P, Donoso Torres H E, Gómez de Liaño Sánchez P, Casco Guijarro J

机构信息

Sección de Motilidad Ocular, Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, España.

Sección de Motilidad Ocular, Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, España.

出版信息

Arch Soc Esp Oftalmol (Engl Ed). 2020 May;95(5):217-222. doi: 10.1016/j.oftal.2020.01.007. Epub 2020 Feb 13.

Abstract

OBJECTIVE

To analyze the strabismus surgeries and the outcomes during a year and a half in a tertiary hospital.

MATERIAL AND METHODS

A retrospective study of patients who underwent strabismus surgery. The mean age, sex, diagnosis, diplopia, surgery, anesthesia, adjustable sutures, results, reoperations and follow up time from surgery were analyzed. A good outcome was considered when the final horizontal deviation was less than 10prism diopters (pd) and the vertical deviation less than 5pd without diplopia.

RESULTS

A total of 153 cases were operated on, mean age: 43.14 ±25.58years (61.4%: women). 74.5% of patients were ≥18years (33.33% ≥60). Diplopia was present in 51% of patients. The most frequent deviation was horizontal: 83.6%. The most frequent diagnosis was cranial nerve palsies: 32% (VI nerve: 12.4%), restrictive strabismus: 7.2%, and the aged related distance esotropia: 6.5%. Adjustable sutures were used in 19.7% of cases and topical anesthesia in 65.4%. Good outcomes was present in 79.2% of cases at the end of follow-up. Reoperations were needed in 25.5%. Follow-up evolution time was 11.87 months ±6.5. The sex female (P=.012) and the oblique superior surgery (P=.017) were associated with bad outcome.

CONCLUSION

The adult strabismus surgery was three times more frequent than the children strabismus surgery. The third of the adults that were operated on were ≥60 years. The cranial nerve palsies were the most frequent diagnosis. Adjustable sutures were rarely used. Good outcomes were obtained in most of the patients at the end of follow-up.

摘要

目的

分析一家三级医院在一年半时间内的斜视手术及手术效果。

材料与方法

对接受斜视手术的患者进行回顾性研究。分析患者的平均年龄、性别、诊断、复视情况、手术方式、麻醉方式、可调节缝线使用情况、手术效果、再次手术情况以及术后随访时间。若最终水平斜视度小于10棱镜度(pd)且垂直斜视度小于5pd且无复视,则认为手术效果良好。

结果

共进行了153例手术,平均年龄:43.14±25.58岁(61.4%为女性)。74.5%的患者年龄≥18岁(33.33%≥60岁)。51%的患者存在复视。最常见的斜视类型为水平斜视:83.6%。最常见的诊断为脑神经麻痹:32%(第六脑神经:12.4%),限制性斜视:7.2%,以及年龄相关性远距离内斜视:6.5%。19.7%的病例使用了可调节缝线,65.4%使用了局部麻醉。随访结束时,79.2%的病例手术效果良好。25.5%的患者需要再次手术。随访时间为11.87个月±6.5个月。女性(P=0.012)和上斜肌手术(P=0.017)与手术效果不佳相关。

结论

成人斜视手术的频率是儿童斜视手术的三倍。接受手术的成人中有三分之一年龄≥60岁。脑神经麻痹是最常见的诊断。可调节缝线很少使用。大多数患者在随访结束时获得了良好的手术效果。

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