Yagasaki Eye Clinic, Ichinomiya, Japan; Department of Ophthalmology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan.
Department of Ophthalmology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan.
J AAPOS. 2020 Apr;24(2):78.e1-78.e5. doi: 10.1016/j.jaapos.2019.12.015. Epub 2020 Mar 26.
To clarify the relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia.
The medical records of otherwise healthy patients with infantile esotropia who underwent surgery by 8 years of age were divided into the following groups according to age at time of surgery: very early surgery (≤8 months), early surgery (>8 to ≤24 months) and late surgery (>24 months). Binocular response and stereopsis were compared between groups.
A total of 76 patients were included: 22 in the very early group, 30 in the early group, and 24 in the late group. Binocular response at near was found in 96% of the very early group and in 80% of the early group, significantly higher than the 50% of the late group (P < 0.001 and P < 0.05 [Dunn test], resp.). Stereopsis was present in 77% of the very early group, significantly higher than the 20% of the early group and 13% of the late group (P < 0.001 [Dunn test]). A significant correlation was also found between age (months) at surgery and stereopsis (seconds) outcome (logarithmic fit: y = 2539.4ln(x) + 147.2; R = 0.2691; P < 0.001).
In this study cohort, earlier surgery was associated with better binocularity in patients with infantile esotropia. Our results suggest that very early surgery, at ≤8 months, can improve the chance for postoperative stereopsis, with the caveat that some infants might have had spontaneous esotropia resolution.
阐明婴幼儿内斜视手术矫正时间与立体视结果的关系。
根据手术时的年龄，将 8 岁以下、患有婴幼儿内斜视且健康状况良好的患者的病历分为以下几组：早期手术（8 个月内）、中期手术（8 个月至 24 个月内）和晚期手术（24 个月后）。比较各组间双眼视功能和立体视锐度。
共纳入 76 例患者：早期组 22 例，中期组 30 例，晚期组 24 例。早期组近距双眼视功能恢复率为 96%，中期组为 80%，均显著高于晚期组的 50%（P < 0.001 和 P < 0.05[Dunn 检验]）。早期组立体视锐度为 77%，显著高于中期组的 20%和晚期组的 13%（P < 0.001[Dunn 检验]）。手术年龄（月）与立体视锐度（秒）结果之间也存在显著相关性（对数拟合：y = 2539.4ln(x) + 147.2；R = 0.2691；P < 0.001）。
在本研究队列中，早期手术与婴幼儿内斜视患者的双眼视功能更好相关。我们的结果表明，8 个月内的极早期手术可以提高术后立体视锐度的机会，但需要注意的是，一些婴儿可能存在自发内斜视缓解。
