J Pediatr Ophthalmol Strabismus. 2024 Sep-Oct;61(5):344-350. doi: 10.3928/01913913-20240508-03. Epub 2024 May 30.
To report long-term ocular alignment and sensory outcomes after medial rectus recession for high accommodative convergence/accommodation (AC/A) ratio esotropia.
The medical records of consecutive patients who had undergone unilateral or bilateral medial rectus recession for high AC/A ratio esotropia and were observed postoperatively for a minimum of 5 years were reviewed retrospectively.
A total of 34 patients were included. Twenty-three patients (68%) used bifocals preoperatively. The mean age at surgery was 11.5 ± 4.4 years (range: 2.5 to 19.0 years). The mean postoperative follow-up was 7.5 ± 2.3 years (range: 5.0 to 15.25 years). Overall, 21 patients (62%) had surgical success at their last follow-up visit. Age at surgery, preoperative angle of distance and near deviation, distance-near disparity, and preoperative bifocal wear did not predict motor outcome after surgery. Preoperative presence of peripheral binocular single vision was a significant favorable factor for surgical success. At the last follow-up visit, 21% of patients had a recurrence of high AC/A ratio esotropia and 9% each had consecutive exotropia (intermittent [3%] and constant [6%]) and basic esotropia. Peripheral binocular single vision was achieved in 64% of patients and stereopsis in 28%. Bifocal segment was eliminated postoperatively in 70% of patients.
Nearly two-thirds of patients with high AC/A ratio esotropia achieved a successful long-term motor outcome and peripheral binocular single vision, and nearly one-fourth achieved stereopsis. Recurrence of high AC/A ratio esotropia occurred in some patients, and consecutive exotropia and basic esotropia in a few. Bifocal segment was eliminated postoperatively in 70% of patients. .
报告高调节性集合/调节（AC/A）比率内斜视患者行内直肌后退术后的长期眼球对准和感觉结果。
回顾性分析了连续接受单侧或双侧内直肌后退术治疗高 AC/A 比率内斜视并术后至少随访 5 年的患者的病历。
共纳入 34 例患者。术前 23 例（68%）患者使用双光镜。手术时的平均年龄为 11.5 ± 4.4 岁（范围：2.5 至 19.0 岁）。平均术后随访时间为 7.5 ± 2.3 年（范围：5.0 至 15.25 年）。总体而言，21 例患者（62%）在末次随访时手术成功。手术时的年龄、术前远距和近距斜视角度、远近距离差异以及术前双光镜佩戴情况并不能预测手术的运动结果。术前存在周边双眼单视是手术成功的显著有利因素。末次随访时，21%的患者出现高 AC/A 比率内斜视复发，9%的患者分别出现间歇性连续外斜视（3%）和恒定性连续外斜视（6%）和基本性内斜视。64%的患者获得周边双眼单视，28%的患者获得立体视。70%的患者术后消除了双光镜部分。
近三分之二的高 AC/A 比率内斜视患者获得了成功的长期运动结果和周边双眼单视，近四分之一的患者获得了立体视。一些患者出现高 AC/A 比率内斜视复发，少数患者出现连续外斜视和基本性内斜视。70%的患者术后消除了双光镜部分。
