State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie Nan Road, Guangzhou, 510060, China.
Int Ophthalmol. 2024 Jun 25;44(1):278. doi: 10.1007/s10792-024-03206-6.
Strabismus reoperation in Graves' ophthalmopathy (GO) is complicated and challenging. The purpose of this study was to evaluate the various surgical strategies of strabismus reoperation and their outcomes in patients with GO.
A retrospective study was conducted on strabismus reoperations performed at the Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China from 2008 to 2018. Data collected included sex, age at surgery, duration of deviation, ocular alignment, ocular motility, various surgical procedures performed and surgical outcomes. Surgical methods included rectus recession for newly developed strabismus, rectus resection for undercorrection and anterior advancement of a previously recessed rectus for overcorrection. Surgical success was defined as an absence of diplopia, a horizontal deviation of ≤ 10 prism diopters (PD) and a vertical deviation of ≤ 5 PD at distance in primary and reading positions.
Of the 153 GO patients receiving strabismus surgery, 27 cases (20 males, 7 females) underwent reoperation for strabismus, with a reoperation rate of 17.6%. Success rates of reoperation in patients with a previous undercorrection and overcorrection were 45% and 71.4%, respectively. Success rates of rectus recession, rectus resection and anterior advancement were 47.1%, 66.7% and 50%, respectively. Two patients underwent the third surgery. The overall success rate was 51.9%.
Rectus recession is an effective method for GO patients with newly-developed strabismus. Rectus resection may benefit some patients with undercorrection who underwent a maximal degree of rectus recession. Anterior advancement of a previously recessed rectus is effective for cases with overcorrection.
Graves 眼病（GO）的斜视再手术较为复杂且具有挑战性。本研究旨在评估 GO 患者斜视再手术的各种手术策略及其结果。
回顾性分析 2008 年至 2018 年中山大学中山眼科中心的斜视再手术病例。收集的数据包括性别、手术年龄、偏斜持续时间、眼球运动、手术方式和手术结果。手术方法包括新出现斜视行直肌后退术，欠矫行直肌切除术，过矫行已后退直肌前徙术。手术成功定义为无复视，正前方注视时水平斜视度≤10 棱镜度（PD），垂直斜视度≤5 PD。
153 例 GO 患者中，27 例（20 例男性，7 例女性）行斜视再手术，再手术率为 17.6%。既往欠矫和过矫患者的再手术成功率分别为 45%和 71.4%。直肌后退术、直肌切除术和直肌前徙术的成功率分别为 47.1%、66.7%和 50%。2 例患者行第三次手术，总体成功率为 51.9%。
直肌后退术是治疗 GO 新发生斜视的有效方法。对于已行最大程度直肌后退术的欠矫患者，直肌切除术可能有益。对于过矫患者，已后退直肌的前徙术是有效的。
