Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China.
BMC Ophthalmol. 2024 Oct 11;24(1):446. doi: 10.1186/s12886-024-03712-2.
To compare and analyze clinical characteristics of patients undergoing two surgeries and multiple surgeries and explore relevant factors to lay the foundation for clinical prediction.
A retrospective analysis was conducted on clinical data from all patients who underwent twice and multiple strabismus surgeries at Tianjin Eye Hospital between October 2012 and September 2021. Patients were divided into Group A (two surgeries) and Group B (more than two surgeries) based on the cumulative number of surgeries performed. Clinical details at the first recurrence, including sex, age, native place, overall medical history, onset time, visual acuity, affected muscle(s), etc., were documented. Non-parametric tests and chi-square tests were used to analyze clinical characteristics in each group. Binary and ordered logistic regression analysis assessed parameters associated with multiple reoperations. A linear mixed-term model observed factors impacting affected muscle(s) during surgery. Researchers examined clinical traits related to secondary strabismus variables.
Among the 910 included patients, 840 required two surgeries (Group A) and 70 underwent more than two surgeries (Group B). Significant differences were found in age, onset time, interval time, and secondary factors. Regression analysis highlighted the significant impact of interval time on the reoperation rate, effectively predicting outcomes in patients with concomitant strabismus. Other ophthalmoplegia and secondary factors significantly influenced reoperation rates in patients with non-concomitant strabismus. Interval time, esotropia, and exotropia were linked to concomitant secondary strabismus patients, while the number of surgeries, DVD, esotropia, exotropia, and esotropia V-pattern were associated with non-concomitant secondary strabismus patients. In a longitudinal study, patients with multiple surgeries showed a correlation between the vertical deviation angle magnitude and the number of involved extraocular muscles. Regression analysis revealed that in patients with concomitant strabismus, interval time, exotropia, and esotropia influenced the total number of muscles during surgery. For patients with non-concomitant strabismus, interval time, secondary factors, and SOP impacted the total number of muscles during surgery.
Interval time in patients with concomitant strabismus, as well as secondary and other ophthalmoplegia in non-concomitant strabismus, are the main factors for multiple reoperations.
比较和分析两次手术和多次手术患者的临床特征，探讨相关因素，为临床预测奠定基础。
回顾性分析 2012 年 10 月至 2021 年 9 月在天津市眼科医院接受两次和多次斜视手术的所有患者的临床资料。根据手术次数的累积，患者分为 A 组（两次手术）和 B 组（两次以上手术）。记录首次复发时的临床详细信息，包括性别、年龄、籍贯、总体病史、发病时间、视力、受累肌肉等。采用非参数检验和卡方检验对各组的临床特征进行分析。二项和有序逻辑回归分析评估与多次手术相关的参数。线性混合项模型观察手术中影响受累肌肉的因素。研究人员检查与继发性斜视变量相关的临床特征。
在纳入的 910 例患者中，840 例需要两次手术（A 组），70 例需要两次以上手术（B 组）。年龄、发病时间、间隔时间和继发性因素存在显著差异。回归分析突出了间隔时间对再次手术率的显著影响，有效地预测了伴有斜视患者的结果。其他眼肌麻痹和继发性因素对非伴有斜视患者的再次手术率有显著影响。间隔时间、内斜视和外斜视与伴有继发性斜视患者相关，而手术次数、DVD、内斜视、外斜视和内斜视 V 型与非伴有继发性斜视患者相关。在一项纵向研究中，多次手术患者的垂直偏差角度大小与受累眼外肌数量之间存在相关性。回归分析显示，在伴有斜视的患者中，间隔时间、外斜视和内斜视影响手术中的总肌肉数量。对于非伴有斜视的患者，间隔时间、继发性因素和 SOP 影响手术中的总肌肉数量。
伴有斜视患者的间隔时间，以及非伴有斜视患者的继发性和其他眼肌麻痹，是多次手术的主要因素。
