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马来西亚一家教学医院水平斜视手术的视觉预后及影响手术预后的因素:五年经验

Visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a teaching hospital in Malaysia: A 5-year experience.

作者信息

Waheeda-Azwa Hussein, Norihan Ibrahim, Tai Evelyn Li Min, Kueh Yee Cheng, Shatriah Ismail

机构信息

Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

出版信息

Taiwan J Ophthalmol. 2020 Feb 12;10(4):278-283. doi: 10.4103/tjo.tjo_71_19. eCollection 2020 Oct-Dec.

Abstract

PURPOSE

The available data on strabismus surgery in South East Asian countries are scarce. This study aimed to identify visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a Southeast Asian cohort.

MATERIALS AND METHODS

A retrospective review of patients who underwent horizontal strabismus surgery between 2013 and 2017 in Hospital Universiti Sains Malaysia was conducted. Surgery was considered successful if the post-operative deviation was within 10 prism diopters at 6 months' postoperative period. Factors influencing the outcome of surgery at 6 months were identified. Chi-square and Fisher's exact tests were used in data analysis.

RESULTS

Ninety-eight patients were included. Both genders were equally affected. Exotropia (58.2%) was the most common type. About 65.3% of patients had alternating strabismus, while 51% had an angle of deviation of more than 45 prism diopters. Amblyopia was documented in 14.3% of patients. Those operated on below 10 years of age comprised 64.3%. Ninety-four patients completed follow-ups at 6 months after the surgery. The success rate was 81.6%. Approximately 92% of the patients had best-corrected visual acuities of 6/12 and better at 6 months' postoperative period. There was no significant association between age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity with surgical outcome at 6 months' postoperative period ( > 0.05).

CONCLUSION

The success rate was good. Postoperative best-corrected visual acuity was promising. Age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity did not influence the outcome of horizontal strabismus surgery in our review.

摘要

目的

东南亚国家斜视手术的现有数据稀缺。本研究旨在确定东南亚队列中水平斜视手术的视觉结果及影响手术结果的因素。

材料与方法

对2013年至2017年在马来西亚理科大学医院接受水平斜视手术的患者进行回顾性研究。如果术后6个月时的术后斜视度在10棱镜度以内,则认为手术成功。确定影响术后6个月手术结果的因素。数据分析采用卡方检验和Fisher精确检验。

结果

纳入98例患者。男女受影响程度相同。外斜视(58.2%)是最常见的类型。约65.3%的患者为交替性斜视,而51%的患者斜视度超过45棱镜度。14.3%的患者有弱视记录。10岁以下接受手术的患者占64.3%。94例患者在术后6个月完成随访。成功率为81.6%。术后6个月时,约92%的患者最佳矫正视力达到6/12及以上。发病年龄、性别、弱视的存在、斜视类型、斜视度以及术后最佳矫正视力与术后6个月的手术结果之间无显著相关性(>0.05)。

结论

成功率良好。术后最佳矫正视力前景乐观。在我们的研究中,发病年龄、性别、弱视的存在、斜视类型、斜视度以及术后最佳矫正视力均不影响水平斜视手术的结果。

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本文引用的文献

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Factors associated with surgical success in adult patients with exotropia.成人外斜视患者手术成功的相关因素。
J AAPOS. 2016 Dec;20(6):511-514. doi: 10.1016/j.jaapos.2016.08.011. Epub 2016 Nov 1.
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Outcomes of 3 or 4 Horizontal Muscles Surgery in Large-Angle Exotropia.大角度外斜视水平肌3或4条肌肉手术的疗效
Asia Pac J Ophthalmol (Phila). 2015 Jul-Aug;4(4):208-11. doi: 10.1097/APO.0000000000000057.
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Psychosocial implications of strabismus surgery in adults.成人斜视手术的社会心理影响
J Pediatr Ophthalmol Strabismus. 1997 May-Jun;34(3):159-64. doi: 10.3928/0191-3913-19970501-06.

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