Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea.
Acta Ophthalmol. 2021 Nov;99(7):e1206-e1211. doi: 10.1111/aos.14771. Epub 2021 Feb 2.
To determine the effect of age on the reoperation rate in children undergoing exotropia surgery.
This was a population-based retrospective cohort study using claims data that included children ≤ 12 years who had undergone exotropia surgery as the first strabismus operation and had ≥ 3 years of continuous enrolment were selected from the Optum de-identified Clinformatics Data Mart Database (2003-2019). Patient age at the first exotropia surgery was grouped into three categories; 0-3, 4-6, and 7-12 years. We assessed the sex, race, age, surgical methods, continuous enrolment period after the first surgery, and the time between the first surgery and reoperation. Cox regression analysis was used to estimate the risk of reoperation at different ages. The hazard ratio of reoperation in children undergoing exotropia surgery according to the age at the first exotropia surgery.
Among 2015 children, 312 (15.5%) underwent one or more reoperations. A reoperation was more often performed for recurrent exotropia (n = 231) than for consecutive esotropia (n = 81). The time between the first surgery and reoperation was shorter for reoperation for consecutive esotropia (376 days) than for recurrent exotropia (672 days) (p < 0.001). Younger children showed a higher reoperation hazard ratio than older children (p < 0.001). In reoperation for consecutive esotropia, the patients aged 0-3 years showed a high hazard ratio (2.82; 95% CI, 1.59-5.01).
Children undergoing exotropia surgery at a younger age have a higher reoperation rate than those undergoing surgery at an older age.
确定年龄对儿童外斜视手术再手术率的影响。
这是一项基于人群的回顾性队列研究，使用来自 Optum 去识别 Clinformatics Data Mart 数据库（2003-2019 年）的理赔数据，纳入首次外斜视手术且连续入组时间≥3 年的≤12 岁儿童。将首次外斜视手术时的患者年龄分为三组：0-3 岁、4-6 岁和 7-12 岁。评估患者的性别、种族、年龄、手术方法、首次手术后的连续入组时间以及首次手术与再手术之间的时间。采用 Cox 回归分析评估不同年龄的再手术风险。根据首次外斜视手术时的年龄，评估儿童外斜视手术再手术的风险比。
在 2015 名儿童中，312 名（15.5%）接受了一次或多次再手术。与连续内斜视（81 例）相比，复发性外斜视（231 例）更常进行再手术。连续内斜视的再手术（376 天）与复发性外斜视（672 天）之间的时间间隔更短（p<0.001）。与年龄较大的儿童相比，年龄较小的儿童再手术的风险比更高（p<0.001）。在连续内斜视的再手术中，0-3 岁的患者显示出较高的风险比（2.82；95%CI，1.59-5.01）。
与年龄较大的儿童相比，年龄较小的儿童行外斜视手术的再手术率更高。
