Department of Ophthalmology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
PLoS One. 2020 Jun 1;15(6):e0234017. doi: 10.1371/journal.pone.0234017. eCollection 2020.
We report the long-term surgical results of augmented lateral rectus muscle (LR) recession for dissociated horizontal deviation (DHD) without concomitant exotropia (XT) or esotropia (ET). This retrospective review included patients with DHD without XT or ET who underwent augmented LR recession and were followed-up for ≥12 months. Each patient's medical records were evaluated to identify their demographics, preoperative angle of deviation, surgical procedure, success rate, and reoperation rate. A total of 11 patients with DHD were included (median patient age at surgery, 6 years; interquartile range [IQR], 5 to 10 years). Four patients (36.4%) had a history of infantile ET while three patients (27.3%) had a history of unilateral cataract surgery for congenital cataract. The median preoperative angle of DHD in the unilateral eye was 20 prism diopters (PD) (IQR, 15 to 25 PD). The median amount of LR recession was 8.0 mm (IQR, 7.5 to 8.0 mm). Three patients (27.3%) underwent simultaneous surgery for dissociated vertical deviation. At the final examination after a median follow-up period of 32 months (IQR, 24 to 58 months), 10 patients (91%) showed successful alignment. The long-term successful alignment rate after augmented LR recession for DHD was good; thus, application of this technique is appropriate in patients with DHD.
我们报告了不伴有外斜视（XT）或内斜视（ET）的分离性水平斜视（DHD）患者行增强外直肌（LR）后退术的长期手术结果。本回顾性研究纳入了行增强 LR 后退术且随访时间≥12 个月的 DHD 且不伴 XT 或 ET 的患者。评估每位患者的病历以确定其人口统计学资料、术前斜视角度、手术过程、成功率和再次手术率。共纳入 11 例 DHD 患者（手术时中位年龄为 6 岁；四分位距 [IQR]，5 至 10 岁）。4 例（36.4%）有婴儿期 ET 病史，3 例（27.3%）有单侧先天性白内障行白内障手术史。单侧眼术前 DHD 斜视角度中位数为 20 棱镜度（PD）（IQR，15 至 25 PD）。LR 后退的中位数距离为 8.0mm（IQR，7.5 至 8.0mm）。3 例（27.3%）同时行分离性垂直斜视手术。在中位随访 32 个月（IQR，24 至 58 个月）后的最终检查中，10 例（91%）患者获得成功的眼位。因此，对于 DHD 患者，增强 LR 后退术是一种合适的治疗选择，其长期成功的眼位保持率良好。
