单侧内直肌后退-外直肌缩短术治疗婴幼儿内斜视的长期运动和感觉结果。
Long-term Motor and Sensory Outcomes After Unilateral Medial Rectus Recession-Lateral Rectus Resection for Infantile Esotropia.
出版信息
J Pediatr Ophthalmol Strabismus. 2024 Mar-Apr;61(2):106-113. doi: 10.3928/01913913-20230721-01. Epub 2023 Aug 24.
PURPOSE
To report long-term motor and sensory outcomes after unilateral medial rectus recession-lateral rectus resection for infantile esotropia.
METHODS
The medical records of patients who had undergone unilateral medial rectus recession-lateral rectus resection for infantile esotropia and were followed up postoperatively for a minimum of 10 years were reviewed retrospectively.
RESULTS
A total of 100 patients were included. The mean age at surgery was 2.9 ± 2.2 years (range: 2.5 months to 9.0 years). The mean postoperative follow-up was 15.7 ± 4.4 years (range:10.0 to 27.5 years). Overall, 54 patients (54%) had surgical success at their last follow-up visit. Age at first surgery, strabismus duration, degree of hyperopia, preoperative size of deviation, presence of dissociated vertical deviation, inferior oblique overaction, or both dissociated vertical deviation and inferior oblique overaction, and the number of esotropia surgeries did not predict motor outcome after surgery. Consecutive exotropia developed in 43% of patients (constant in 18% and intermittent in 25%). Residual and recurrent esotropia occurred in 20% and 21% of patients, respectively. Refractive accommodative esotropia developed in 17% of patients and there was a high accommodation convergence/accommodation ratio esotropia in 2%. Peripheral binocular single vision was achieved in 54% of patients and stereopsis in 1%. Patients with 1.5 years or less of strabismus duration had better chances of achieving peripheral binocular single vision.
CONCLUSIONS
Nearly half of the patients with infantile esotropia achieved a successful long-term motor outcome and peripheral binocular single vision. Consecutive exotropia occurred frequently. Recurrent esotropia and refractive accommodative esotropia developed in some patients, and a high accommodation convergence/accommodation ratio esotropia in a few. Stereopsis outcome was extremely poor. .
目的
报告单侧内直肌后退-外直肌切除术治疗婴儿内斜视的长期运动和感觉结果。
方法
回顾性分析了 100 例接受单侧内直肌后退-外直肌切除术治疗婴儿内斜视并至少随访 10 年的患者的病历。
结果
平均手术年龄为 2.9±2.2 岁（范围：2.5 个月至 9.0 岁）。平均术后随访时间为 15.7±4.4 年（范围：10.0 至 27.5 年）。总的来说，54 例（54%）患者在最后一次随访时手术成功。首次手术年龄、斜视持续时间、远视程度、术前斜视度数、是否存在分离性垂直斜视、下斜肌过强或同时存在分离性垂直斜视和下斜肌过强、以及斜视手术次数均不能预测手术的运动结果。43%的患者出现继发黄视（恒定性 18%，间歇性 25%）。20%的患者出现残余内斜视，21%的患者出现复发内斜视。17%的患者出现屈光性调节性内斜视，2%的患者出现高调节性集合/调节性内斜视。54%的患者获得周边双眼单视，1%的患者获得立体视。斜视持续时间 1.5 年或更短的患者获得周边双眼单视的可能性更大。
结论
近一半的婴儿内斜视患者获得了长期运动结果和周边双眼单视。继发黄视发生率较高。部分患者出现复发内斜视和屈光性调节性内斜视，少数患者出现高调节性集合/调节性内斜视。立体视结果极差。
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