Teope Jonnah Kristina, Umezawa Naomi, Takahashi Yasuhiro
Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan.
Department of Ophthalmology, Aichi Medical University, Nagakute 480-1195, Aichi, Japan.
Medicina (Kaunas). 2025 Mar 21;61(4):559. doi: 10.3390/medicina61040559.
The purpose of this study was to evaluate the outcome of lateral rectus (LR) muscle resection for new-onset or worsening esotropia after medial orbital wall decompression in patients with thyroid eye disease. This retrospective observational study included 20 patients. Preoperative and postoperative measurements of ocular deviation angles and fields of binocular single vision (BSV) were performed one day before and three months after surgery. Surgical success was defined as postoperative horizontal ocular deviation ≤ 5° and BSV including the primary position. Factors influencing a reduction in the esodeviation angle were analyzed using univariate and multivariate linear regression analyses. Eighteen patients (90.0%) were deemed as successful surgical cases. The esodeviation angle decreased from 19.4 ± 11.2° to 1.0 ± 2.6°. In multivariate analysis, a reduction in the esodeviation angle was correlated with the presence of dysthyroid optic neuropathy ( = 0.027), amounts of LR muscle resection in mild eyes ( = 0.014), and amounts of additional medial rectus muscle recession in severe eyes ( < 0.001). LR muscle resection showed a high success rate in correcting new-onset or worsening esotropia which developed after medial orbital wall decompression. Several factors influencing a reduction in the esodeviation angle were found.
本研究的目的是评估甲状腺眼病患者眶内侧壁减压术后新发或加重的内斜视行外直肌（LR）肌肉切除术的疗效。这项回顾性观察性研究纳入了20例患者。术前1天及术后3个月进行了眼位偏斜角度和双眼单视（BSV）范围的测量。手术成功定义为术后水平眼位偏斜≤5°且BSV包括第一眼位。采用单因素和多因素线性回归分析影响内斜视角度减小的因素。18例患者（90.0%）被视为手术成功病例。内斜视角度从19.4±11.2°降至1.0±2.6°。多因素分析显示，内斜视角度减小与甲状腺相关性视神经病变的存在（=0.027）、轻度眼外直肌切除量（=0.014）以及重度眼内直肌后退额外量（<0.001）相关。外直肌切除术在矫正眶内侧壁减压术后新发或加重的内斜视方面显示出较高的成功率。发现了几个影响内斜视角度减小的因素。
