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菲律宾马尼拉一家三级医院的感觉性外斜视手术结果

Surgical Outcomes for Sensory Exotropia in a Tertiary Hospital in Manila, Philippines.

作者信息

Torrefranca Aramis B, Santiago Alvina Pauline D, Pejana Alyssa Louise B

机构信息

Department of Ophthalmology and Visual Sciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

Department of Ocular Health, Governor Celestino Gallares Memorial Medical Center, Tagbilaran City, Bohol, Philippines.

出版信息

Acta Med Philipp. 2024 Nov 29;58(21):66-70. doi: 10.47895/amp.vi0.8485. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVE

There is no strict by-the-book rule as to which approach is the best strabismus surgery for patients with sensory exotropia. More commonly, a monocular lateral rectus recession and a medial rectus resection (monocular R & R; MRR) is performed in the eye with a poorer prognosis. Rarely, for larger deviations, a third or fourth horizontal muscle in the better eye is added. This study aimed to determine the outcomes of strabismus surgery performed for sensory exotropia in a tertiary hospital in the Philippines.

METHODS

The medical records of all patients with sensory exotropia who underwent strabismus surgical correction from January 2015 to December 2019 were retrospectively reviewed.

RESULTS

A total of 29 medical records satisfied the inclusion criteria. Mean age at diagnosis and at the time of surgery were 7.5 ± 11.6 (range: 1 to 68 years) and 12.4 ± 16.2 years (range: 1 to 68 years) years old, respectively, with a mean follow-up of 6.2 months (range: 3 to 24 months). After a mean follow-up of 6.2 months, the overall success (alignment in primary position is within 10 prism diopters of orthotropia) was relatively low, where 34% were successful, 65.5% developed recurrence, and none had overcorrections. Survival plots of both surgeries revealed a decline in success probability in achieving desired alignment six months after surgery.

CONCLUSION

We reported the surgical outcomes of 29 patients with sensory exotropia. The general trend realized was that the decline in success rates of good alignment was evident beginning six months post-operatively. The retrospective design serves as a limitation and hence, readers should treat results with caution.

摘要

背景与目的

对于感觉性外斜视患者,哪种斜视手术方法是最佳选择,并没有严格的循规蹈矩的规则。更常见的情况是,在预后较差的眼睛上进行单眼外直肌后徙和内直肌缩短术(单眼R&R;MRR)。很少情况下,对于较大的斜视度,会在较好的眼睛上增加一条第三或第四条水平肌手术。本研究旨在确定菲律宾一家三级医院为感觉性外斜视患者实施斜视手术的效果。

方法

回顾性分析2015年1月至2019年12月期间所有接受斜视手术矫正的感觉性外斜视患者的病历。

结果

共有29份病历符合纳入标准。诊断时和手术时的平均年龄分别为7.5±11.6岁(范围:1至68岁)和12.4±16.2岁(范围:1至68岁),平均随访6.2个月(范围:3至24个月)。平均随访6.2个月后,总体成功率(第一眼位对齐在正位视10棱镜度以内)相对较低,其中34%成功,65.5%复发,无过矫病例。两种手术的生存曲线显示,术后六个月实现期望对齐的成功概率下降。

结论

我们报告了29例感觉性外斜视患者的手术结果。总体趋势是,术后六个月开始,良好对齐的成功率明显下降。回顾性设计是一个局限性,因此,读者应谨慎对待结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bc7/11694030/a88c437e2290/AMP-58-21-8485-g001.jpg

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