Srimanan Worapot
Division of Ophthalmology, Phramongkutklao Hospital, Ratchathewi, Bangkok, Thailand.
Clin Ophthalmol. 2024 Jul 8;18:1945-1958. doi: 10.2147/OPTH.S470050. eCollection 2024.
Several studies reported surgical outcomes for abducens nerve palsy, but information on factors that affect treatment success remains lacking. These factors are crucial for developing a treatment plan and providing disease counseling. This study aimed to investigate the outcomes of strabismus surgery for abducens nerve palsy and determine the factors that influence its success, including a review of relevant literature.
This retrospective analysis included abducens nerve palsy cases, focusing on surgical interventions and relevant patient data, at the outpatient clinics of Phramongkutklao Hospital from April 1, 2012, to April 30, 2022. A relevant literature review included the surgical success rate and factors that influence surgical outcomes.
This study enrolled 32 patients, including 19 with partial and 13 with complete abducens nerve palsy. The overall success rate of strabismus surgery was 78.1%. Trauma was the leading cause of abducens nerve palsy in this population (28.13%). Fisher's exact and Mann-Whitney -tests revealed that shorter abducens nerve palsy onset and smaller preoperative angle were significantly associated with successful surgical outcomes of strabismus surgery among the groups. In contrast, subgroup analysis revealed that only preoperative smaller angles were significantly associated with good surgical outcomes in horizontal strabismus surgery. However, the vertical rectus muscle transposition group demonstrated no significant factors. The literature review revealed that the success rate of surgery in abducens nerve palsy was 25%-82.6% for horizontal rectus muscle surgery and 46.2%-91% for rectus muscle transposition.
The surgical success rate for abducens nerve palsy reached 78.1%, including 78.95% for partial and 76.92% for complete abducens nerve palsy. Notably, a shorter onset preceding surgery and a smaller preoperative angle significantly correlated with successful surgical outcomes one year postoperatively.
多项研究报告了外展神经麻痹的手术结果，但仍缺乏关于影响治疗成功因素的信息。这些因素对于制定治疗计划和提供疾病咨询至关重要。本研究旨在调查外展神经麻痹斜视手术的结果，并确定影响其成功的因素，包括对相关文献的综述。
这项回顾性分析纳入了2012年4月1日至2022年4月30日在诗里蒙坤贴医院门诊就诊的外展神经麻痹病例，重点关注手术干预措施和相关患者数据。相关文献综述包括手术成功率和影响手术结果的因素。
本研究纳入32例患者，其中19例为部分性外展神经麻痹，13例为完全性外展神经麻痹。斜视手术的总体成功率为78.1%。创伤是该人群外展神经麻痹的主要原因（28.13%）。费舍尔精确检验和曼-惠特尼检验显示，外展神经麻痹发病时间较短和术前角度较小与各组斜视手术的成功手术结果显著相关。相比之下，亚组分析显示，在水平斜视手术中，只有术前较小的角度与良好的手术结果显著相关。然而，垂直直肌转位组未显示出显著因素。文献综述显示，外展神经麻痹水平直肌手术的成功率为25%-82.6%，直肌转位手术的成功率为46.2%-91%。
外展神经麻痹的手术成功率达到78.1%，其中部分性外展神经麻痹为78.95%，完全性外展神经麻痹为76.92%。值得注意的是，术前发病时间较短和术前角度较小与术后一年的成功手术结果显著相关。
