Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
Department of Ophthalmology, Faculty of medicine, Vajira Hospital, Bangkok, Thailand.
J Binocul Vis Ocul Motil. 2022 Oct-Dec;72(4):205-211. Epub 2022 Aug 29.
Age-related divergence insufficiency-esotropia (ARDIE) is characterized by greater esodeviation at distance than near. This study aims to compare the outcomes of unilateral and bilateral surgical approaches.
Sixty-two cases treated at the Kellogg Eye Center, the University of Michigan, from 1995 to 2018 were retrospectively reviewed. One surgeon used unilateral procedures including unilateral medial rectus recession (n = 24, group 1) or unilateral recession-resection (n = 18, group 2) with an adjustable suture. Another surgeon used bilateral medial rectus recession with fixed sutures (n = 20, group 3).
For patients with distance esodeviation <15∆, postoperative distance deviations in both group 1 and group 3 were not statistically different (p = .352). For patients with esodeviations 15-20∆, postoperative distance deviations in all 3 groups were also not statistically different (p = .142). Similarly, patients with deviations >20∆ did not show significantly different postoperative distance alignment (p = .082) between group 2 and 3. Overall, group 2 had the highest overall success rate (90%) (mean at distance = 1.17∆ exodeviation, at near = 2.33∆ exodeviation).
Both unilateral medial rectus recession ± lateral rectus resection and bilateral medial rectus recession surgical approaches produced similar favorable outcomes in ARDIE.
与年龄相关的发散不足性内斜视（ARDIE）的特征是远距离内斜视大于近距离内斜视。本研究旨在比较单侧和双侧手术方法的结果。
回顾性分析了 1995 年至 2018 年在密歇根大学凯洛格眼科中心治疗的 62 例患者。一位外科医生使用单侧手术，包括单侧内直肌后退（n=24，第 1 组）或单侧后退-截骨术（n=18，第 2 组），并使用可调节缝线。另一位外科医生使用双侧内直肌后退固定缝线（n=20，第 3 组）。
对于远距离内斜视<15∆的患者，第 1 组和第 3 组的术后远距离斜视差异无统计学意义（p=0.352）。对于内斜视 15-20∆的患者，三组的术后远距离斜视差异也无统计学意义（p=0.142）。同样，对于斜视>20∆的患者，第 2 组和第 3 组的术后远距离斜视也没有明显差异（p=0.082）。总体而言，第 2 组的总体成功率最高（90%）（远距离平均斜视 1.17∆，近距离平均斜视 2.33∆）。
单侧内直肌后退±外直肌切除术和双侧内直肌后退手术方法在 ARDIE 中均产生相似的良好结果。
