Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA.
J Binocul Vis Ocul Motil. 2022 Jul-Sep;72(3):147-150. Epub 2022 Jun 23.
Compared to bilateral horizontal rectus muscle recessions (BHR), a unilateral horizontal rectus muscle recession (UHR) confers shorter operating time and anesthesia exposure, limits complication risks to one eye, and requires less recovery from the patient.
Retrospective chart review of pediatric patients who underwent unilateral medial rectus recession (UMR) for esotropia (ET), or unilateral lateral rectus recession (ULR) for exotropia (XT). Primary successes were defined as maximum distance deviation at post-operative month 3: -12 to +5 for ET, -5 to +12 for XT. Rates of postoperative horizontal incomitance (HI) >5 PD and success for small medium, and large (in mm, respectively, ET: <5, 5-6 mm, >6; XT: <8, 8-10, >10) recessions were analyzed.
Seventeen ETs and 40 XTs were analyzed. Overall primary success was 71.9% (p = .02). Significantly, 80% (95% CI: 67.60,92.40) XTs succeeded. ETs were equally likely to succeed (53.9%) or fail (47.1%) (p = .22). For patients without significant preoperative HI, average postoperative HI was 3.90 PD (95% CI: 0.20, 7.60) for ETs; 5.48 PD (95% CI: 3.65, 7.32) for XTs.
UHR was 71.9% successful in treating pediatric comitant strabismus. ULR for XT, particularly small to medium deviations, was most likely to succeed. In contrast to prior reports, large UMR and ULR were less likely to succeed and post-operative incomitance was frequent but rarely clinically significant.
与双侧水平直肌后退术（BHR）相比，单侧水平直肌后退术（UHR）可缩短手术时间和麻醉暴露时间，将并发症风险限制在一只眼睛，并减少患者的恢复时间。
回顾性分析接受单侧内直肌后退术（UMR）治疗内斜视（ET）或单侧外直肌后退术（ULR）治疗外斜视（XT）的儿科患者的病历。主要成功定义为术后 3 个月的最大距离偏差：ET 为-12 至+5，XT 为-5 至+12。分析术后水平不等视（HI）>5 PD 的发生率以及小、中、大（分别为 ET：<5、5-6mm、>6mm；XT：<8、8-10mm、>10mm）后退术的成功率。
分析了 17 例 ET 和 40 例 XT。总体主要成功率为 71.9%（p=0.02）。显著的是，80%（95%可信区间：67.60，92.40）的 XT 成功。ET 同样可能成功（53.9%）或失败（47.1%）（p=0.22）。对于术前无明显 HI 的患者，ET 的平均术后 HI 为 3.90 PD（95%可信区间：0.20，7.60）；XT 为 5.48 PD（95%可信区间：3.65，7.32）。
UHR 治疗小儿共同性斜视的成功率为 71.9%。对于 XT，特别是小至中度偏差，ULR 最有可能成功。与先前的报告不同，大的 UMR 和 ULR 不太可能成功，术后不等视是常见的，但很少有临床意义。
