Yetkin Ali A
Department of Ophthalmology, Adiyaman University Faculty of Medicine, Adiyaman, TUR.
Cureus. 2024 Nov 29;16(11):e74758. doi: 10.7759/cureus.74758. eCollection 2024 Nov.
Horizontal strabismus is a binocular alignment disorder that can lead to significant complications in childhood, such as visual impairment and amblyopia. This study aimed to evaluate the success rates of horizontal strabismus surgery in pediatric patients and to identify the factors affecting surgical outcomes. Specifically, it examined the relationship between surgical success and factors such as age, deviation angle, and amblyopia in pediatric horizontal strabismus cases.
The medical records of 95 patients diagnosed with horizontal strabismus and treated surgically between 2016 and 2022 were reviewed. Surgical success was defined by a postoperative deviation angle of less than 10 prism diopters (PD). Visual acuity and deviation angles were measured before and after surgery, and the data were analyzed statistically.
Among the cases, 49 (51.5%) were diagnosed with esotropia and 46 (48.5%) with exotropia. One year after surgery, the overall success rate was recorded at 73.6%. The success rates were 77.6% in the esotropia group and 69.6% in the exotropia group, with no statistically significant difference between the groups (p=0.515). In age-based analyses, the surgical success rate was 73.8% in patients aged 0-9 years and 73.5% in those aged 10-18 years. Patients with a deviation angle greater than 45 PD had a success rate of 61.5%, while those with an angle below 45 PD achieved a success rate of 82.1% (p<0.05). Surgical success was observed in 50% of patients with amblyopia and 80.9% of those without amblyopia. Improvement in visual acuity was observed in 5.5% of non-amblyopic patients and in 22.7% of amblyopic patients; however, this improvement was not statistically correlated with surgical success.
This study revealed that factors such as the deviation angle and the presence of amblyopia affected the success rate of horizontal strabismus surgery. Surgical success rates did not differ significantly between esotropia and exotropia cases. Consistent with existing literature, patients with larger deviation angles and amblyopia were found to have lower surgical success rates.
水平斜视是一种双眼视轴对准障碍，可导致儿童期出现严重并发症，如视力损害和弱视。本研究旨在评估小儿患者水平斜视手术的成功率，并确定影响手术结果的因素。具体而言，研究了小儿水平斜视病例中手术成功率与年龄、斜视角度和弱视等因素之间的关系。
回顾了2016年至2022年间95例诊断为水平斜视并接受手术治疗的患者的病历。手术成功的定义为术后斜视角度小于10棱镜度（PD）。在手术前后测量视力和斜视角度，并对数据进行统计分析。
在这些病例中，49例（51.5%）被诊断为内斜视，46例（48.5%）为外斜视。术后一年，总体成功率为73.6%。内斜视组成功率为77.6%，外斜视组为69.6%，两组之间无统计学显著差异（p = 0.515）。在基于年龄的分析中，0至9岁患者的手术成功率为73.8%，10至18岁患者为73.5%。斜视角度大于45 PD的患者成功率为61.5%，而斜视角度低于45 PD的患者成功率为82.1%（p < 0.05）。弱视患者的手术成功率为50%，非弱视患者为80.9%。非弱视患者中有5.5%的视力得到改善，弱视患者中有22.7%的视力得到改善；然而，这种改善与手术成功无统计学相关性。
本研究表明，斜视角度和弱视等因素会影响水平斜视手术的成功率。内斜视和外斜视病例的手术成功率无显著差异。与现有文献一致，发现斜视角度较大和患有弱视的患者手术成功率较低。
