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1-6 岁婴儿斜视手术后的结果和影响因素。

Postoperative outcome and influencing factors of strabismus surgery in infants aged 1-6 years.

机构信息

Department of Ophthalmology and Optometry, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Jul;262(7):2299-2307. doi: 10.1007/s00417-024-06404-1. Epub 2024 Feb 16.

Abstract

PURPOSE

To evaluate the postoperative outcome of strabismus surgery performed in children aged 1-6 years by investigating the change of the preoperative angle of deviation (AOD), elevation in adduction, best-corrected visual acuity (BCVA) and refractive error.

METHODS

Retrospective chart review of 62 children who received strabismus surgery between January 2018 and December 2021 at the Department of Ophthalmology and Optometry of the Medical University of Vienna. Age, sex, type of strabismus, AOD, BCVA, refractive error and visual acuity were evaluated with respect to the postoperative outcome.

RESULTS

Mean follow-up was 13.55 ± 11.38 months with a mean age of 3.94 ± 1.97 years (range: 1.0-6.0) at time of surgery. 74.19% of patients (n = 46) had isolated or combined esotropia, 12.90% (n = 8) had isolated or combined exotropia and 12.90% (n = 8) had isolated strabismus sursoadductorius. Mean preoperative AOD of 15.69 ± 16.91°/15.02 ± 14.88° (near/distance) decreased to 4.00 ± 9.18°/4.83 ± 7.32° (near/distance) at final follow-up (p < 0.001). BCVA improved from 0.26 ± 0.26/0.25 ± 0.23 (left/right) to 0.21 ± 0.25/0.20 ± 0.23 (left/right) (p = 0.038). There was no significant change regarding refractive error (p = 0.109) or elevation in adduction (p = 0.212). Success rate which was defined as a residual AOD of less than 10° was 74.19% (n = 46). In 3.23% (n = 2) retreatment was necessary.

CONCLUSION

Strabismus surgery in infants was shown to have a satisfactory outcome with a low retreatment rate. Surgical success rate was not linked to age, sex, type of strabismus or the preoperative parameters AOD, refractive error and visual acuity in this study.

摘要

目的

通过研究术前斜视角度(AOD)、内收提升、最佳矫正视力(BCVA)和屈光不正的变化,评估 1-6 岁儿童斜视手术后的结果。

方法

回顾性分析 2018 年 1 月至 2021 年 12 月在维也纳医科大学眼科和验光科接受斜视手术的 62 名儿童的图表。评估年龄、性别、斜视类型、AOD、BCVA、屈光不正和视力与术后结果的关系。

结果

平均随访时间为 13.55±11.38 个月,手术时平均年龄为 3.94±1.97 岁(范围:1.0-6.0)。74.19%(n=46)的患者为单纯或合并内斜视,12.90%(n=8)为单纯或合并外斜视,12.90%(n=8)为单纯斜视 sursoadductorius。术前 AOD 平均为 15.69±16.91°/15.02±14.88°(近/远),最终随访时降至 4.00±9.18°/4.83±7.32°(近/远)(p<0.001)。BCVA 从 0.26±0.26/0.25±0.23(左/右)提高到 0.21±0.25/0.20±0.23(左/右)(p=0.038)。屈光不正(p=0.109)或内收提升(p=0.212)无显著变化。残留 AOD<10°的成功率为 74.19%(n=46)。3.23%(n=2)需要再次治疗。

结论

本研究表明,婴儿斜视手术结果令人满意,复发率低。手术成功率与年龄、性别、斜视类型或术前 AOD、屈光不正和视力等参数无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57fe/11222223/eff2cf8dc987/417_2024_6404_Fig1_HTML.jpg

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