Department of Ophthalmology, Vitreoretinal Section, Zealand University Hospital, Naestved, Denmark.
Department of Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, Iowa, USA.
Acta Ophthalmol. 2022 Feb;100(1):e71-e76. doi: 10.1111/aos.14888. Epub 2021 Jul 26.
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.
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.
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.
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.
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。
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。
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。
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。