Fu Joa-Jing, Hsieh Meng-Wei, Lee Lung-Chi, Chen Po-Liang, Wen Liang-Yen, Chen Yi-Hao, Chien Ke-Hung
Dr. Fu Eye Clinic, Taipei, Taiwan.
Department of Ophthalmology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan.
Front Med (Lausanne). 2022 Feb 24;9:791068. doi: 10.3389/fmed.2022.791068. eCollection 2022.
Pediatric strabismus surgery has low success rates and high reoperation rates because of difficult alignment measurements and the nature of different strabismus types. Furthermore, adjustable sutures are not easily employed in children on an OPD basis.
This was a retrospective comparative case study of children less than 12 years old who underwent strabismus surgery and were followed up at least 6 months postoperatively. We proposed a novel method that combines adjustable sutures and corneal light reflexes in regular strabismus surgery to improve surgical results. Efficacy and safety were evaluated and compared with those in a regular fixed-suture group.
In total, 128 children (88: exotropia and 41: esotropia) in the novel method group (Group 1) and 109 (71: exotropia and 38: esotropia) in the regular fixed-suture group (Group 2) were enrolled. The primary outcome was the immediate target angle (for esotropia within 4 PD of orthotropia and exotropia within 8 PD of esotropia within the first week postoperatively); the secondary outcome was success at the 6-month visit (angle of deviation < 10 PD). Consequently, there was a significantly higher proportion of achieving the immediate target range and success rate in both exotropic and esotropic patients in Group 1 than in Group 2. A significantly lower reoperation rate was also demonstrated in Group 1. No complications were noted in either group. The novel method enabled a higher proportion of subjects to achieve an immediate target range and success rate and a lower chance of reoperation among both esotropic and exotropic patients.
由于斜视测量困难以及不同斜视类型的特点，小儿斜视手术成功率低且再次手术率高。此外，在门诊基础上，儿童不易使用可调节缝线。
这是一项回顾性比较病例研究，研究对象为12岁以下接受斜视手术并在术后至少随访6个月的儿童。我们提出了一种新方法，即在常规斜视手术中结合可调节缝线和角膜光反射，以提高手术效果。评估其有效性和安全性，并与常规固定缝线组进行比较。
新方法组（第1组）共纳入128例儿童（88例：外斜视和41例：内斜视），常规固定缝线组（第2组）共纳入109例（71例：外斜视和38例：内斜视）。主要结局是即刻目标角度（内斜视术后第一周内正位偏差在4棱镜度以内，外斜视术后第一周内隐斜在8棱镜度以内）；次要结局是术后6个月时成功（偏斜角度<10棱镜度）。因此，第1组中外斜视和内斜视患者实现即刻目标范围和成功率的比例均显著高于第2组。第1组的再次手术率也显著较低。两组均未观察到并发症。新方法使更高比例的受试者实现即刻目标范围和成功率，并且使内斜视和外斜视患者再次手术的几率降低。
