Wang Huihang, Zheng Weidong
Department of Ophthalmology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Ophthalmology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Front Med (Lausanne). 2024 Apr 15;11:1389201. doi: 10.3389/fmed.2024.1389201. eCollection 2024.
This study aims to explore more accurate and efficient examination methods to provide precise target surgical measurements for patients with type III acute acquired comitant esotropia (AACE).
The study conducted a retrospective analysis of 108 patients diagnosed with AACE who received surgical treatment at the Department of Ophthalmology, the First Affiliated Hospital of Fujian Medical University, from January 2018 to September 2023. All patients underwent examinations of the deviation angle, including the Hirschberg test, prism and Maddox rod test (PMT), and prism and alternate cover test (PACT). For the PACT, the minimum value (PACTmin) and maximum value (PACTmax) were obtained based on differences in examination methods, as well as the deviation angle range (PACT range), which represents the difference between PACTmax and PACTmin. Postoperatively, these patients were followed up for at least 6 months to assess changes in eye position and whether diplopia symptoms recurred.
In both near and distant examinations, the results of PACTmax were significantly greater than those of PACTmin ( < 0.001), while the deviation angles obtained from PACTmax and PMT showed no significant statistical difference [ = 0.689 (33 cm), = 0.436 (5 m)]. There was a strong linear correlation between PACTmin and PMT at both near ( = 0.8887) and distant ( = 0.8950) distances, but each PACTmin corresponded to multiple PMT values. There was no significant difference between the results of PACT range at near and distant distances ( = 0.531). The deviation angles obtained by PMT and PACTmin significantly decreased postoperatively compared to preoperative values, and diplopia disappeared in all patients, with alternative cover test showing no movement or presenting as an esophoria state.
The PMT can provide precise target surgical measurements for type III AACE, making it a fast, effective, and cost-efficient examination method. It is worthy of being promoted and applied in clinical practice.
本研究旨在探索更准确、高效的检查方法，为III型急性后天性共同性内斜视（AACE）患者提供精确的手术靶点测量。
本研究对2018年1月至2023年9月在福建医科大学附属第一医院眼科接受手术治疗的108例诊断为AACE的患者进行回顾性分析。所有患者均接受了斜视角度检查，包括角膜映光法、三棱镜加马多克斯杆试验（PMT）和三棱镜交替遮盖试验（PACT）。对于PACT，根据检查方法的差异获得最小值（PACTmin）和最大值（PACTmax），以及代表PACTmax与PACTmin之差的斜视角度范围（PACT范围）。术后对这些患者进行至少6个月的随访，以评估眼位变化及复视症状是否复发。
在近距和远距检查中，PACTmax的结果均显著大于PACTmin（<0.001），而PACTmax和PMT获得的斜视角度无显著统计学差异[=0.689（33cm），=0.436（5m）]。近距（=0.8887）和远距（=0.8950）时，PACTmin与PMT之间均存在强线性相关性，但每个PACTmin对应多个PMT值。近距和远距时PACT范围的结果无显著差异（=0.531）。与术前值相比，术后PMT和PACTmin获得的斜视角度显著降低，所有患者复视消失，交替遮盖试验显示无眼球运动或呈内隐斜状态。
PMT可为III型AACE提供精确的手术靶点测量，是一种快速、有效且经济高效的检查方法。值得在临床实践中推广应用。
