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视网膜脱离手术后保留或去除巩膜植片的斜视手术比较研究。

A comparative study of strabismus surgery with retained or removed scleral explant after retinal detachment surgery.

机构信息

Department of Ophthalmology, Vitreoretinal Section, Zealand University Hospital, Naestved, Denmark.

Department of Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, Iowa, USA.

出版信息

Acta Ophthalmol. 2022 Feb;100(1):e71-e76. doi: 10.1111/aos.14888. Epub 2021 Jul 26.

Abstract

PURPOSE

To compare, in a larger study population, the outcomes of strabismus surgery in patients who either had the scleral explant (EX) retained or removed after surgery for retinal detachment.

METHODS

A comparative retrospective study includes data from 2 centres. Surgical outcome, motor success, sensory success, the number of secondary operations for strabismus and complications were compared between the two groups. Motor success was defined as horizontal deviation of ≤6 prism diopters (PD) and vertical deviation of ≤6PD. Sensory success was defined as no diplopia without use of prism.

RESULTS

Forty-seven patients were included in the study; 70% had retained the EX and 74% had vertical strabismus. Horizontally, the final alignment was equal between the 2 groups, 4 PD vs.5 PD in the EX removed group. The patients with retained EX were referred with a significant lower mean vertical deviation and had a significant lower post-operative mean vertical deviation of 2 PD vs. 3 PD in the EX-removed group. The rates of motor success (76% vs. 71%) and sensory success (79% vs. 93%) did not differ significantly between the EX-retained and EX-removed groups. No patients underwent more than 2 operations. Two complications occurred in the EX-retained group: a subconjunctival cyst and an exposed EX. In the EX-removed group, 2 patients with retinal re-detachment were found in the follow-up period.

CONCLUSION

Good surgical outcomes including high motor and sensory success were obtained regardless of the presence of the EX. Retinal re-detachment was observed in two patients with previously removed EX.

摘要

目的

在更大的研究人群中比较视网膜脱离手术后巩膜植片(EX)保留或去除的患者斜视手术的结果。

方法

一项比较性回顾性研究包括来自两个中心的数据。比较两组间手术结果、运动成功、感觉成功、斜视二次手术次数和并发症。运动成功定义为水平偏差≤6 棱镜度(PD)和垂直偏差≤6PD。感觉成功定义为无复视且不使用棱镜。

结果

本研究纳入 47 例患者;70%保留了 EX,74%存在垂直斜视。水平方向上,两组最终的对齐情况相同,EX 去除组为 4PD,EX 保留组为 5PD。保留 EX 的患者就诊时平均垂直偏差明显较低,术后平均垂直偏差为 2PD,而 EX 去除组为 3PD。运动成功(76%比 71%)和感觉成功(79%比 93%)的比率在 EX 保留组和 EX 去除组之间无显著差异。没有患者接受超过 2 次手术。EX 保留组发生 2 种并发症:结膜下囊肿和 EX 外露。EX 去除组在随访期间发现 2 例视网膜再脱离患者。

结论

无论 EX 是否存在,均可获得良好的手术结果,包括高运动成功率和感觉成功率。在先前去除 EX 的 2 例患者中观察到视网膜再脱离。

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