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成人急性后天性共同性内斜视的手术效果

Surgical outcomes of acute acquired comitant esotropia of adulthood.

作者信息

Kim Dae Hyun, Noh Ha Jeong

机构信息

Department of Ophthalmology, Chosun University Hospital, 365 Pilmundaero, Dong-gu, 61453, Gwang-ju, South Korea.

出版信息

BMC Ophthalmol. 2021 Jan 18;21(1):45. doi: 10.1186/s12886-020-01793-3.

Abstract

BACKGROUND

Acute acquired comitant esotropia (AACE) is a type of strabismus characterized by a sudden onset of large angle esotropia with diplopia, which often occurs in children after infancy, teenagers, and young adolescents. However, studies on the surgical outcomes of only adults are rare. The purpose of this article is to analyze the surgical outcomes for adult patients diagnosed with AACE.

METHODS

Medical records of 24 patients who had undergone surgery for AACE were retrospectively analyzed. The main outcome measures were the final motor and sensory success rate after surgery and factors affecting motor and sensory outcomes. Motor success was considered alignment within 8 prism diopter (PD) at both near and distance and sensory success was stereoacuity ≥ 60 sec/arc.

RESULTS

The preoperative mean esodeviation angles were 33.1 ± 10.4 PD at distance and 33.3 ± 11.2 PD at near. The mean period of postoperative follow up was 7.5 ± 4.5 months (range 1-8 months). The postoperative mean esodeviation angles at final follow-up time were 3.4 ± 6.1 PD at distance and 3.8 ± 6.7 PD at near. The surgical motor success rate at final follow-up was 79.2% (19/24). The sensory success rate at final follow-up was 50.0% (12/24). The factor affecting the motor outcome was the type of surgery (p < 0.05). The factor affecting sensory outcome was postoperative follow-up time (p < 0.05).

CONCLUSIONS

Surgery type appears to affect surgical motor outcomes in adults with AACE. Although the sensory outcome was favorable, it seems that regaining bifoveal fixation takes time.

摘要

背景

急性后天性共同性内斜视(AACE)是一种斜视类型,其特征为突然出现伴有复视的大角度内斜视,常见于婴儿期后的儿童、青少年及年轻成人。然而,仅针对成人手术结果的研究较少。本文旨在分析诊断为AACE的成年患者的手术结果。

方法

回顾性分析24例接受AACE手术患者的病历。主要观察指标为术后最终的运动和感觉成功率以及影响运动和感觉结果的因素。运动成功定义为近距和远距斜视度均在8棱镜度(PD)以内,感觉成功定义为立体视锐度≥60秒/弧。

结果

术前平均远距内斜视角为33.1±10.4 PD,近距为33.3±11.2 PD。术后平均随访时间为7.5±4.5个月(范围1 - 8个月)。末次随访时术后平均远距内斜视角为3.4±6.1 PD,近距为3.8±  6.7 PD。末次随访时手术运动成功率为79.2%(19/24)。末次随访时感觉成功率为50.0%(12/24)。影响运动结果的因素是手术类型(p <0.05)。影响感觉结果的因素是术后随访时间(p <0.05)。

结论

手术类型似乎影响AACE成年患者手术运动结果。尽管感觉结果良好,但恢复双眼中心注视似乎需要时间。

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