Verma Rupal, Singh Anupam, Agrawal Ajai, Samanta Ramanuj, Panyala Rakesh, Waghamare Shalaka, Mittal S K, Kumar Barun
Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh.
Department of Cardiology, All India Institute of Medical Sciences, Rishikesh.
Strabismus. 2020 Dec;28(4):208-214. doi: 10.1080/09273972.2020.1832541. Epub 2020 Oct 16.
To evaluate the surgical outcome of augmented BLR recession with conjunctival recession in cases of IXT.
A total of 15 patients of the basic type of IXT were included in this prospective study. The patients underwent augmented BLR recession with conjunctival recession and on the basis of postoperative deviation, the outcome was assessed in terms OF orthophoria/success (< or =10 PD exotropia and < or =5 PD esotropia), residual exotropia/undercorrection (>10 PD exotropia), and overcorrection (>5 PD esotropia).
Preoperative primary horizontal deviation was 30.80 ± 9.56 PD (16-42 PD) for near (0.3 m) and was 33.93 ± 9.97PD (15-45 PD) for distance (6 m). The mean postoperative primary horizontal deviation was 5.6 ± 1.5 PD (4-8 PD) for distance and 6.73 ± 2.15 PD (4-10 PD) for near at 6 months follow-up. After 12 weeks of surgery, 12 (80%) of the patients were orthophoric, 2 (13.3%) of the patients were overcorrected and 1 (6.7%) of the patient was undercorrected for near and all 15 (100.0%) patients were orthophoric for distance. This alignment was maintained till 6 months of follow-up.
Although fornix-based incisions for squint surgery are preferred these days augmented BLR recession with conjunctival recession by limbal-based incision leads to good surgical outcome and prevents undercorrection and recurrence.
评估在间歇性外斜视（IXT）病例中，联合结膜退缩的增强性下直肌后徙术的手术效果。
本前瞻性研究纳入了15例基本型IXT患者。患者接受了联合结膜退缩的增强性下直肌后徙术，并根据术后斜视度，以正位/成功（外斜视≤10棱镜度（PD）且内斜视≤5 PD）、残余外斜视/矫正不足（外斜视＞10 PD）和过矫（内斜视＞5 PD）来评估手术效果。
术前近距（0.3米）的原发性水平斜视度为30.80±9.56 PD（16 - 42 PD），远距离（6米）为33.93±9.97 PD（15 - 45 PD）。术后6个月随访时，远距离平均原发性水平斜视度为5.6±1.5 PD（4 - 8 PD），近距为6.73±2.15 PD（4 - 10 PD）。术后12周时，12例（80%）患者近距正位，2例（13.3%）患者过矫，1例（6.7%）患者矫正不足，所有15例（100.0%）患者远距离正位。这种眼位矫正情况维持到随访6个月。
尽管如今斜视手术更倾向于采用穹窿部切口，但通过角膜缘切口进行联合结膜退缩的增强性下直肌后徙术可获得良好的手术效果，并防止矫正不足和复发。
