Nune Eye Hospital, Daegu, South Korea.
Department of Medicine, The Graduate School, Kyungpook National University, Daegu, South Korea.
BMC Ophthalmol. 2023 Mar 28;23(1):125. doi: 10.1186/s12886-023-02873-w.
BACKGROUND/AIMS: We evaluate the clinical characteristics of intermittent exotropia with controllability and compare surgical outcomes between patients with and without controllability.
We reviewed the medical records of patients aged 6-18 years with intermittent exotropia who underwent surgery between September 2015 and September 2021. Controllability was defined as the patient's subjective awareness of exotropia or diplopia associated with the presence of exotropia and ability to instinctively correct the ocular exodeviation. Surgical outcomes were compared between patients with and without controllability, with a favorable surgical outcome defined as an ocular deviation between ≤ 10 PD of exotropia and ≤ 4 PD of esotropia at distance and near.
Among 521 patients, 130 (25%, 130/521) had controllability. The mean age of onset (7.7 years) and surgery (9.9 years) were higher in patients with controllability than in those without controllability (p < 0.001). The mean control scores of patients with controllability (distance: 1.9, near: 1.5) were lower compared with patients without controllability (distance: 3.0, near: 2.2), reflecting a better level of control. Patients with controllability had a better surgical outcome than those without controllability, as analyzed by log-rank test (p < 0.001). Larger preoperative ocular exodeviation at distance (hazard ratio [HR] = 1.083, confidence interval [CI] = 1.018-1.151, p = 0.012) and near (HR = 1.102, CI = 1.037-1.172, p = 0.002) were significantly related to recurrence in patients with controllability.
Patients with controllability showed better surgical outcomes, later exotropia onset, and better level of control than patients without controllability. Preoperative ocular exodeviation was a significant factor influencing favorable outcomes in patients with controllable exotropia.
背景/目的：我们评估了间歇性外斜视的临床特征及其可控制性，并比较了具有和不具有可控制性的患者的手术结果。
我们回顾了 2015 年 9 月至 2021 年 9 月期间接受手术的年龄在 6-18 岁的间歇性外斜视患者的病历。可控制性定义为患者主观意识到与外斜视相关的外斜视或复视，并具有本能地矫正眼外斜视的能力。我们比较了具有和不具有可控制性的患者之间的手术结果，将良好的手术结果定义为远距和近距时的眼偏斜度在≤10 个棱镜度（PD）的外斜视和≤4 PD 的内斜视之间。
在 521 名患者中，有 130 名（25%，130/521）具有可控制性。与不具有可控制性的患者相比，具有可控制性的患者的发病年龄（7.7 岁）和手术年龄（9.9 岁）更高（p<0.001）。具有可控制性的患者的控制评分（远距：1.9，近距：1.5）低于不具有可控制性的患者（远距：3.0，近距：2.2），反映了更好的控制水平。对数秩检验分析表明，具有可控制性的患者的手术结果优于不具有可控制性的患者（p<0.001）。更大的术前远距眼外斜视（危险比[HR] = 1.083，置信区间[CI] = 1.018-1.151，p=0.012）和近距眼外斜视（HR = 1.102，CI = 1.037-1.172，p=0.002）与可控制性患者的复发显著相关。
与不具有可控制性的患者相比，具有可控制性的患者表现出更好的手术结果、更晚的外斜视发病和更好的控制水平。术前眼外斜视是影响具有可控制性外斜视患者良好手术结果的重要因素。
