Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi; Centre for Sight, New Delhi, India.
Indian J Ophthalmol. 2022 Mar;70(3):948-951. doi: 10.4103/ijo.IJO_2884_20.
To evaluate the surgical efficacy of reinforced plication of the medial rectus muscle to resection as an effective muscle strengthening procedure in exotropia.
This is a prospective randomized trial in patients with exotropia who underwent complete orthoptic evaluation followed by random assignment into two groups by using a computer-drawn random number table. Group 1 patients underwent standard resection with recession procedure, and group 2 patients underwent reinforced plication with recession procedure. Follow-up was performed at day 1, 1 week, 1 month, 3 months, and 6 months to assess the surgical efficacy.
A total of 80 patients were included in the study of which 39 were in group 1 and 41 in group 2. The mean age in group 1 was 23.48 ± 11.94 years and 23.29 ± 10.02 years in group 2. The mean preoperative deviation in group 1 for distance was 50.13 ± 11.95 PD and 50.12 ± 9.79 PD in group 2 (P = 0.499). In group 1 with a mean surgical dose of 5.27 mm medial rectus resection and 8.04 mm lateral rectus recession, a 7.11 ± 3.95 PD deviation was noted at the end of 6 months. Similarly, in group 2 with a mean surgical dose of 5.16 mm medial rectus plication and 8.16 mm lateral rectus recession, a 6.00 ± 2.46 PD deviation was noted at the end of 6 months. Between groups, ocular surface changes, inter-surgeon comparison, and exotropia subtypes did not reveal any significant differences.
In our observation, the reinforced medial rectus muscle plication showed clinically comparable results as compared to the standard resection procedure at the end of 6 months. Therefore, this innovative modification can be considered as an alternative to standard resection.
评估加强内直肌折叠术作为外斜视矫正术的一种有效肌肉加强方法的手术疗效。
这是一项前瞻性随机试验，纳入了外斜视患者，所有患者均接受了完整的斜视检查，然后通过计算机生成的随机数表将患者随机分为两组。第 1 组患者接受标准的后退术加截除术，第 2 组患者接受加强折叠术加后退术。术后第 1 天、第 1 周、第 1 个月、第 3 个月和第 6 个月进行随访，以评估手术效果。
共有 80 例患者纳入研究，其中第 1 组 39 例，第 2 组 41 例。第 1 组的平均年龄为 23.48 ± 11.94 岁，第 2 组为 23.29 ± 10.02 岁。第 1 组的术前平均远距斜视为 50.13 ± 11.95 PD，第 2 组为 50.12 ± 9.79 PD（P = 0.499）。第 1 组行 5.27 mm 内直肌截除术和 8.04 mm 外直肌后退术，术后 6 个月平均斜视度为 7.11 ± 3.95 PD。同样，第 2 组行 5.16 mm 内直肌折叠术和 8.16 mm 外直肌后退术，术后 6 个月平均斜视度为 6.00 ± 2.46 PD。两组之间，眼表面变化、术者间比较和外斜视亚型均无显著差异。
在我们的观察中，与标准截除术相比，加强内直肌折叠术在术后 6 个月时显示出临床可比的结果。因此，这种创新性的改良可以作为标准截除术的替代方法。
