Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
PLoS One. 2021 Sep 23;16(9):e0257465. doi: 10.1371/journal.pone.0257465. eCollection 2021.
While initial overcorrection after exotropia-correcting surgery is widely accepted for a favorable long-term outcome, some have not advocated such overcorrection in younger children owing to concerns regarding rapid deterioration of bifixation ability. This study aimed to evaluate the relationship between initial overcorrection after intermittent exotropia surgery and the surgical outcome in patients aged <4 years.
In this retrospective study, 391 patients who had undergone surgery for intermittent exotropia were classified into two groups according to the age at surgery: <4 years old (group Y [young], 130 patients) and 4-16 years old (group O [old], 261). The patients were subdivided into three groups according to the angle of deviation at postoperative 1 week: esophoria-tropia (ET) ≥10 prism diopters (PD) (subgroup I), ET 1-9 PD (II), and orthotropia or exophoria-tropia (XT) (III). We compared the surgical outcomes between the two groups and among subgroups; then, we analyzed consecutive esotropia patients.
The mean exodeviation was smaller in the order of subgroup I, II, and III at every postoperative visit (p<0.05) in group Y but showed no difference among subgroups after 2 years in group O. Consecutive esotropia occurred at 1 month, postoperatively, in 6.9% and 2.6% of the patients in groups Y and O (p = 0.133), respectively. However, it persisted in two and one patient in groups Y and O, respectively, until the last visit.
Early overcorrection after intermittent exotropia surgery was a safe and desirable result in terms of motor outcome in children aged under 4 years, as well as for children aged between 4-16 years.
虽然外斜视矫正术后的初始过矫被广泛认为是获得良好长期结果的一种方式，但由于担心双眼固视能力迅速恶化，一些医生不主张对年龄较小的儿童进行这种过矫。本研究旨在评估间歇性外斜视手术后的初始过矫与<4 岁患者手术结果的关系。
在这项回顾性研究中，根据手术年龄将 391 例接受间歇性外斜视手术的患者分为两组：<4 岁（Y 组[年轻]，130 例）和 4-16 岁（O 组[年长]，261 例）。根据术后 1 周的斜视角度将患者分为三组：内斜视-外斜视（ET）≥10 棱镜度（PD）（亚组 I）、ET 1-9 PD（II）和正位或内斜视-外斜视（XT）（III）。我们比较了两组之间以及亚组之间的手术结果，然后对连续内斜视患者进行了分析。
Y 组中，在每个随访时间点，斜视度的顺序为亚组 I、II 和 III，外斜视的平均偏离度较小（p<0.05），但 O 组在 2 年后各组之间无差异。在 Y 组和 O 组中，分别有 6.9%和 2.6%的患者在术后 1 个月时出现连续内斜视（p=0.133），但分别有 2 例和 1 例患者的斜视持续存在，直到最后一次随访。
对于<4 岁的儿童，间歇性外斜视手术后的早期过矫在运动结果方面是安全且理想的，对于 4-16 岁的儿童也是如此。
