Sefi-Yurdakul Nazife, Gucyetmez Volkan
Department of Ophthalmology, Başkent University Zübeyde Hanım Hospital, İzmir, Turkey.
Department of Ophthalmology, Maltepe State Hospital, İstanbul, Turkey.
Middle East Afr J Ophthalmol. 2020 Jul 20;27(2):117-122. doi: 10.4103/meajo.MEAJO_150_19. eCollection 2020 Apr-Jun.
The purpose of this study is to evaluate the results of myectomy in inferior oblique overaction cases with a vertical deviation angle of <20 and ≥20 prism diopters (PD) in the primary position.
The medical records of cases with inferior oblique overaction that underwent inferior oblique myectomy for ≥6 PD hypertropia in the primary position and >+1 inferior oblique overaction were reviewed. Preoperative and postoperative examination findings and success rates were compared of cases with a deviation angle <20 PD (Group 1) and ≥20 PD (Group 2).
The mean age of 35 (58%) female and 25 (42%) men cases of Group 1 ( = 60) were 12.8 ± 9.4 years; the mean age of 25 (58%) female and 18 (42%) male cases of Group 2 ( = 43) were 14.8 years ( = 0.340). The near hypertropia was decreased from 11 to 0.5 PD in Group 1, from 22.1 to 5.1 PD in Group 2 cases ( < 0.001). The distance hypertropia was decreased from 11.3 to 0.5 PD in Group 1 and from 23.3 to 6.1 PD in Group 2 cases ( < 0.001). The mean degree of hypertropia at near and distance was statistically significantly higher both pre- and post-operatively in Group 2 than in Group 1 ( < 0.001), and improved statistically significantly with the initial surgery in both groups ( < 0.001). The rate of the presence of stereopsis of ≥3000 s/arc and fusion, the main criteria of binocular vision (BOV), was not statistically significantly different between the Groups before ( = 0.577) and after the surgery ( = 0.678), but the presence of BOV significantly increased both in Group 1 ( < 0.001) and Group 2 ( = 0.004) postoperatively. The number of cases with surgical success was 57 (95%) and 25 (58%), respectively, in Groups 1 and 2 ( < 0.001).
Myectomy is an effective surgical procedure that can be easily and quickly performed in inferior oblique overaction cases and has high success rates in cases with a small-to-moderate angle of deviation.
本研究旨在评估在第一眼位垂直偏斜角度<20和≥20棱镜度（PD）的下斜肌亢进病例中行下斜肌切除术的效果。
回顾性分析在第一眼位因≥6 PD上斜视且下斜肌亢进>+1而行下斜肌切除术的病例的病历。比较偏斜角度<20 PD组（第1组）和≥20 PD组（第2组）术前和术后的检查结果及成功率。
第1组60例患者中，35例（58%）为女性，25例（42%）为男性，平均年龄为12.8±9.4岁；第2组43例患者中，25例（58%）为女性，18例（42%）为男性，平均年龄为14.8岁（P = 0.340）。第1组近距离上斜视从11 PD降至0.5 PD，第2组从22.1 PD降至5.1 PD（P<0.001）。第1组远距离上斜视从11.3 PD降至0.5 PD，第2组从23.3 PD降至6.1 PD（P<0.001）。第2组术前和术后近距离及远距离上斜视的平均度数在统计学上均显著高于第1组（P<0.001），且两组初次手术后均有统计学上的显著改善（P<0.001）。双眼视觉（BOV）的主要标准，即≥3000秒/弧立体视和融合的存在率，术前（P = 0.577）和术后（P = 0.678）两组间无统计学显著差异，但术后第1组（P<0.001）和第2组（P = 0.004）BOV的存在率均显著增加。第1组和第2组手术成功的病例数分别为57例（95%）和25例（58%）（P<0.001）。
下斜肌切除术是一种有效的手术方法，在下斜肌亢进病例中操作简便快捷，在中小角度偏斜病例中成功率高。
