Han So Young, Han Jinu, Lee Jong Bok, Han Sueng-Han
Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine.
Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine.
Medicine (Baltimore). 2020 Sep 4;99(36):e21401. doi: 10.1097/MD.0000000000021401.
To compare the surgical outcomes of medial rectus advancement and lateral rectus recession in postoperative consecutive exotropia with single-stage adjustable suture surgery.Among 1003 patients who underwent bilateral medial rectus recession between November 1996 and March 2013, the patients who required surgery for consecutive exotopia were retrospectively reviewed. Nineteen patients underwent medial rectus advancement and 15 patients underwent lateral rectus recession. All patients underwent single-stage adjustable surgery under topical anesthesia and were followed up for at least 12 months.The mean follow-up duration was 2.4 years. At final follow-up, a successful surgical outcome was found in 12 patients (63.0%) in the medial rectus advancement group and 14 patients (93.3%) in the lateral rectus recession group (P = .039). The change in ocular deviation was correlated with the amount of recession (P = .008) and preoperative angle (P < .001) in the lateral rectus recession group.Lateral rectus recession showed a higher success rate with predictable and easily performed procedure than medial rectus advancement for the treatment of postoperative consecutive exotropia with adjustable suture.
比较单阶段可调节缝线手术治疗术后连续性外斜视时内直肌徙前术与外直肌后徙术的手术效果。在1996年11月至2013年3月期间接受双侧内直肌后徙术的1003例患者中，对需要手术治疗连续性外斜视的患者进行回顾性研究。19例患者接受内直肌徙前术，15例患者接受外直肌后徙术。所有患者均在表面麻醉下接受单阶段可调节手术，并随访至少12个月。平均随访时间为2.4年。在末次随访时，内直肌徙前术组12例患者（63.0%）手术结果成功，外直肌后徙术组14例患者（93.3%）手术结果成功（P = 0.039）。外直肌后徙术组眼位偏斜的变化与后徙量（P = 0.008）和术前斜视角度（P < 0.001）相关。对于采用可调节缝线治疗术后连续性外斜视，外直肌后徙术比内直肌徙前术成功率更高，手术过程可预测且操作简便。
