Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
Can J Ophthalmol. 2021 Jun;56(3):166-170. doi: 10.1016/j.jcjo.2020.10.006. Epub 2020 Nov 5.
To review the clinical features of acute acquired concomitant esotropia in myopia and the results of augmented bilateral symmetrical medial rectus recession.
The medical charts of 50 patients diagnosed with acute acquired concomitant esotropia associated with myopia between 2013 and 2018 were reviewed. The dose-response was calculated, and the relationship of sex, age, refraction, best-corrected visual acuity (BCVA), preoperative deviation angle, and stereopsis with surgical results were analysed.
Forty-six patients (mean age 40.1 ± 18.1 years) were included in the study. Preoperative esotropia angle at near and distance were, respectively, 26.0 ± 7.5 PD and 25.2 ± 7.9 PD. Surgery amount was 12.1 ± 1.8 mm of recession, and surgical success was achieved in 38 patients (82.6%). No overcorrections were recorded. At 1-year follow-up, the mean deviation angle at distance and at near was 1.9 ± 2.4 and 1.7 ± 2.1 PD, and no recurrences were observed. The average dose-response was 1.8 ± 0.6 PD/mm and was positively correlated with preoperative angle of deviation (R = 0.799, p < 0.001) and negatively correlated with age (R = -0.365, p = 0.013). Conversely, there were no significant associations between dose-response and sex, refractive error, BCVA, or stereopsis (all p > 0.05). Factors associated with surgical failure were a lower amount of recession and absence of stereopsis.
Augmented bilateral medial rectus recession allows good motor and sensory results in patients with acute acquired concomitant esotropia associated with myopia.
回顾近视性急性获得性共同性内斜视的临床特征及双侧内直肌等量后退术的疗效。
回顾 2013 年至 2018 年间诊断为近视性急性获得性共同性内斜视的 50 例患者的病历。计算剂量反应，分析性别、年龄、屈光不正、最佳矫正视力（BCVA）、术前斜视角度和立体视与手术结果的关系。
本研究纳入 46 例患者（平均年龄 40.1±18.1 岁）。近距和远距斜视术前角度分别为 26.0±7.5 PD 和 25.2±7.9 PD。手术量为 12.1±1.8 mm 的内直肌后退，38 例（82.6%）患者手术成功，无过矫。1 年随访时，远距和近距平均斜视角度分别为 1.9±2.4 PD 和 1.7±2.1 PD，无复发。平均剂量反应为 1.8±0.6 PD/mm，与术前斜视角度呈正相关（R=0.799，p<0.001），与年龄呈负相关（R=-0.365，p=0.013）。相反，剂量反应与性别、屈光不正、BCVA 或立体视之间均无显著相关性（均 p>0.05）。手术失败的相关因素是后退量较少和缺乏立体视。
双侧内直肌等量后退术可使近视性急性获得性共同性内斜视患者获得良好的运动和感觉效果。
