Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Ophthalmology, Osaka Red Cross Hospital, Osaka, Japan.
Eye (Lond). 2024 Dec;38(17):3252-3257. doi: 10.1038/s41433-024-03270-3. Epub 2024 Jul 26.
BACKGROUND/OBJECTIVES: To investigate whether the corrective effect differs between upward and downward transpositions or between exotropia and esotropia in vertical transposition accompanied by horizontal rectus muscle recession-resection.
SUBJECTS/METHODS: This prospective study investigated 41 patients with concomitant exotropia or esotropia with small-angle vertical deviation who underwent unilateral vertical transposition accompanied by horizontal rectus muscle recession-resection and were followed up for 1 year postoperatively. We analysed the vertical deviation corrective effect, defined as the corrective amount per displacement distance (°/tendon width [TW]). We compared the corrective effects between upward and downward transpositions and between exotropia and esotropia. Additionally, we investigated the correlation between the corrective effect and the studied parameters.
The 1-year vertical corrective effect was 5.2 ± 4.6° (9.0 ± 8.1 prism dioptres [Δ])/TW. The 1-year vertical corrective effect of upward transposition (7.9 ± 4.0° [13.8 ± 7.0Δ]/TW) was higher than that of the downward transposition (3.9 ± 4.4° [6.8 ± 7.7Δ]/TW, P = 0.009). In contrast, upward and downward transposition did not differ between exotropia and esotropia (P = 0.62). Multivariate analyses revealed that the 1-year vertical corrective effect correlated with the vertical transposition direction (upward or downward) and preoperative vertical deviation but did not correlate with the disease type (exotropia or esotropia). The 1-year motor success (vertical deviation ≤ 5Δ) rate was 89%.
The vertical corrective effect of vertical transposition accompanied by horizontal rectus muscle recession-resection is greater in upward transposition than in downward transposition; however, it does not differ between exotropia and esotropia.
背景/目的：探讨在伴有水平直肌后退-截除的垂直斜视中，上转和下转以及外斜视和内斜视之间的矫正效果是否存在差异。
对象/方法：本前瞻性研究纳入了 41 例伴有小角度垂直斜视的共同性外斜视或内斜视患者，这些患者均接受了单侧垂直移位术，并伴有水平直肌后退-截除，术后随访 1 年。我们分析了垂直偏斜的矫正效果，定义为每位移距离的矫正量（°/肌腱宽度 [TW]）。我们比较了上转和下转以及外斜视和内斜视之间的矫正效果。此外，我们还研究了矫正效果与研究参数之间的相关性。
术后 1 年的垂直矫正效果为 5.2±4.6°（9.0±8.1 棱镜屈光度 [Δ]）/TW。上转的 1 年垂直矫正效果（7.9±4.0° [13.8±7.0Δ]/TW）高于下转（3.9±4.4° [6.8±7.7Δ]/TW，P=0.009）。然而，上转和下转在外斜视和内斜视之间没有差异（P=0.62）。多变量分析显示，1 年的垂直矫正效果与垂直移位方向（上转或下转）和术前垂直偏斜相关，但与疾病类型（外斜视或内斜视）无关。1 年的运动成功率（垂直偏斜≤5Δ）为 89%。
伴有水平直肌后退-截除的垂直斜视矫正中，上转的垂直矫正效果大于下转，但外斜视和内斜视之间没有差异。
