Lee Donghun, Yang Hee Kyung, Hwang Jeong-Min
Department of Ophthalmology, Daegu Catholic University School of Medicine, Daegu, South Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumiro 173 beon-gil, Bundang-gu, Seongnam, 13620, Gyeonggi, South Korea.
Sci Rep. 2025 Feb 17;15(1):5775. doi: 10.1038/s41598-024-77293-x.
We investigated the long-term outcomes of unilateral medial rectus (UMR) recession surgery in partially accommodative esotropia (PAET). Children aged ≤ 10 years with PAET who had residual esotropia of ≤ 25 prism diopters (PD) after full hypermetropic correction and underwent UMR recession were included. Medical records of patients who were followed up for at least 1 year postoperatively were retrospectively reviewed. Successful outcome was defined as phoria of ≤ 5 PD. Total of 28 patients were included. The mean preoperative esodeviation at distance fixation was 15.5 ± 3.7 PD (range, 10-25 PD). The mean dose of UMR recession was 5.6 ± 0.7 mm (range, 4.0-7.0 mm). The average postoperative follow-up time was 4.4 ± 3.1 years. At the last examination, esodeviation significantly decreased to 6.2 ± 13.8 PD and the surgical success rate was 53.6%. In the success group, the age at surgery was older (P = 0.005), the duration of wearing prism glasses was longer (P = 0.030), and the amount of UMR recession was greater (P < 0.001) than in the failure group. Only half of the patients with small to moderate angle PAET achieved successful long-term outcomes through UMR recession. Having sufficient time to wear prism glasses before surgery to achieve good binocularity and receiving a sufficient amount of surgical correction may improve surgical success.
我们研究了部分调节性内斜视(PAET)患者行单眼内直肌(UMR)后徙术的长期疗效。纳入年龄≤10岁、完全矫正远视后残余内斜视≤25棱镜度(PD)且接受UMR后徙术的PAET患儿。对术后至少随访1年的患者病历进行回顾性分析。成功结局定义为隐斜度≤5 PD。共纳入28例患者。远距离注视时术前平均内斜视度为15.5±3.7 PD(范围10 - 25 PD)。UMR后徙的平均量为5.6±0.7 mm(范围4.0 - 7.0 mm)。术后平均随访时间为4.4±3.1年。在最后一次检查时,内斜视度显著降至6.2±13.8 PD,手术成功率为53.6%。成功组手术时年龄较大(P = 0.005),佩戴棱镜眼镜的时间较长(P = 0.030),UMR后徙量较大(P < 0.001),均高于失败组。只有一半的轻至中度PAET患者通过UMR后徙术获得成功的长期疗效。术前有足够时间佩戴棱镜眼镜以获得良好双眼视功能以及接受足够量的手术矫正可能会提高手术成功率。