Umazume F, Ohtsuki H, Hasebe S
Department of Ophthalmology, Okayama University Medical School, Japan.
Jpn J Ophthalmol. 1997 Mar-Apr;41(2):89-97. doi: 10.1016/s0021-5155(97)00007-5.
To identify preoperative factors which influence the effectiveness of strabismus surgery in adults, we retrospectively reviewed the records of 179 patients > 15 years old (131 with exotropia, 48 with esotropia) who had had combined recession and resection surgery for correction of horizontal strabismus. Eighteen preoperative variables were evaluated; those with significant influence on the surgical outcome, measured by the degree of change in deviation per millimeter of surgery, were identified by stepwise regression analysis. In patients with exotropia, preoperative distance deviation and average spherical equivalent were significant predictors of outcome at both 1 month (multiple R, 0.37) and 6 months (0.63) after surgery. In esotropic patients, significant variables at 1 month (multiple R, 0.57) and 6 months (0.77) were preoperative distance deviation and dissociated vertical deviation (DVD). Preoperative distance deviation is the common significant influence on surgical effectiveness for horizontal strabismus in adults, for both exotropia and esotropia. Additional significant predictors are average spherical equivalents in exotropic patients, and DVD in esotropic patients.
为了确定影响成人斜视手术效果的术前因素，我们回顾性分析了179例年龄超过15岁的患者（131例外斜视，48例内斜视）的记录，这些患者接受了用于矫正水平斜视的后退和切除联合手术。评估了18个术前变量；通过逐步回归分析确定了那些对手术结果有显著影响的变量，手术结果通过每毫米手术偏差变化程度来衡量。在外斜视患者中，术前远距离斜视度和平均球镜度数是术后1个月（复相关系数，0.37）和6个月（0.63）时手术结果的显著预测因素。在内斜视患者中，术后1个月（复相关系数，0.57）和6个月（0.77）时的显著变量是术前远距离斜视度和分离性垂直偏斜（DVD）。术前远距离斜视度是成人水平斜视手术效果的共同显著影响因素，对外斜视和内斜视均如此。其他显著预测因素在外斜视患者中是平均球镜度数，在内斜视患者中是DVD。
