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单侧外直肌后徙-内直肌切除术治疗婴儿恒定性外斜视的长期运动和感觉预后

Long-term Motor and Sensory Outcomes After Unilateral Lateral Rectus Recession-Medial Rectus Resection for Infantile Constant Exotropia.

作者信息

Mohan Kanwar, Sharma Suresh Kumar

出版信息

J Pediatr Ophthalmol Strabismus. 2025 May-Jun;62(3):203-210. doi: 10.3928/01913913-20241210-04. Epub 2025 Jan 21.

Abstract

PURPOSE

To report long-term motor and sensory outcomes after unilateral lateral rectus recession-medial rectus resection for infantile constant exotropia.

METHODS

The medical records of patients who had undergone unilateral lateral rectus recession-medial rectus resection for infantile constant exotropia who were followed up postoperatively for a minimum of 4 years were reviewed retrospectively.

RESULTS

A total of 20 patients were included. The mean age at surgery was 3.21 ± 1.54 years (range: 1.25 to 6.00 years). The mean duration of exodeviation was 2.99 ± 1.61 years (range: 9 months to 6 years). The mean angle of exodeviation was 70.1 ± 20.9 prism diopters (PD) (range: 35 to 90 PD). The median postoperative follow-up was 9.1 years (range: 4 to 24 years). Overall, 12 patients (60%) had surgical success at their last follow-up visit. Age at first surgery, cycloplegic refraction, strabismus duration, preoperative angle of deviation, presence of amblyopia, and the number of exotropia surgeries did not predict motor outcome after surgery. At the last follow-up visit, 20% of patients had residual exotropia and 15% had recurrent exotropia. Peripheral binocular single vision was achieved in 25% of patients and stereopsis in none. Age at first surgery, strabismus duration, and surgical outcome had no effect on sensory outcome.

CONCLUSIONS

In this study, 60% of patients achieved a successful long-term motor outcome and 25% achieved peripheral binocular single vision after unilateral recession-resection for infantile constant exotropia. Stereopsis outcome was nil. Age at surgery and duration of strabismus had no effect on motor and sensory outcomes. .

摘要

目的

报告单侧外直肌后徙术-内直肌切除术治疗婴儿恒定性外斜视的长期运动和感觉预后。

方法

回顾性分析接受单侧外直肌后徙术-内直肌切除术治疗婴儿恒定性外斜视且术后随访至少4年的患者的病历。

结果

共纳入20例患者。手术时的平均年龄为3.21±1.54岁(范围:1.25至6.00岁)。外斜视的平均持续时间为2.99±1.61年(范围:9个月至6年)。外斜视的平均角度为70.1±20.9三棱镜度(PD)(范围:35至90 PD)。术后中位随访时间为9.1年(范围:4至24年)。总体而言,12例患者(60%)在最后一次随访时手术成功。首次手术年龄、睫状肌麻痹验光、斜视持续时间、术前偏斜角度、弱视的存在以及外斜视手术次数均不能预测术后运动预后。在最后一次随访时,20%的患者有残余外斜视,15%的患者有复发性外斜视。25%的患者获得周边双眼单视,无一例获得立体视。首次手术年龄、斜视持续时间和手术结果对感觉预后无影响。

结论

在本研究中,单侧后徙-切除术治疗婴儿恒定性外斜视后,60%的患者获得了成功的长期运动预后,25%的患者获得了周边双眼单视。立体视预后为零。手术年龄和斜视持续时间对运动和感觉预后无影响。

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