Chiu Tzu-Yu, Cheng Ming-Chieh, Wei Yi-Hsuan, Liao Shu-Lang
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
College of Medicine, National Taiwan University, Taipei, Taiwan.
Eur J Ophthalmol. 2025 Jan;35(1):239-244. doi: 10.1177/11206721241258330. Epub 2024 May 29.
Persistent diplopia after rectus muscle myectomy is not uncommon but challenging in patients with Graves' ophthalmopathy. We investigated the role of lateral rectus muscle resection for patients after medial rectus muscle myectomy in Graves' ophthalmopathy.
We retrospectively reviewed and collected data from patients with persistent diplopia after medial rectus muscle myectomy for Graves' ophthalmopathy who underwent unilateral or bilateral lateral rectus muscle resection. The eyeball deviations in the primary and reading positions before and after the operation were measured. A successful surgical outcome was defined as having less than five prism diopters (PD) in the primary gaze and functional binocular vision in the central 30° field postoperatively.
A total of fifteen patients were included (mean post-myectomy deviation: 35.9 PD, range: 14 to -75 PD). The lateral rectus muscle resection after medial rectus muscle myectomy achieved an 80.0% success rate, with one patient over-corrected and two patients under-corrected.
The lateral rectus muscle resection is an effective and predictable procedure for managing residual esotropia in Graves' ophthalmopathy patients who have previously undergone medial rectus muscle myectomy.
在格雷夫斯眼病患者中，直肌切除术之后持续存在复视的情况并不少见，但颇具挑战性。我们研究了外直肌切除术对格雷夫斯眼病患者内直肌切除术后患者的作用。
我们回顾性分析并收集了因格雷夫斯眼病行内直肌切除术后出现持续性复视且接受单侧或双侧外直肌切除术患者的数据。测量手术前后第一眼位和阅读位时的眼球偏斜度。手术成功的定义为术后第一眼位棱镜度小于5棱镜度（PD）且中央30°视野内具有功能性双眼视觉。
共纳入15例患者（平均肌切除术后偏斜度：35.9 PD，范围：14至-75 PD）。内直肌切除术后行外直肌切除术的成功率为80.0%，1例患者矫正过度，2例患者矫正不足。
对于先前已行内直肌切除术的格雷夫斯眼病患者，外直肌切除术是治疗残余内斜视的一种有效且可预测的方法。
