单侧内直肌截除术治疗儿童残余性和复发性外斜视的疗效观察  

Efficacy of unilateral medial rectus resection in children with residual and recurrent exotropia

作　　者：王涛[1] 杨相泽[1] 王利华[2] Tao Wang;Xiang-Ze Yang;Li-Hua Wang(Department of Ophthalmology,Weihai Municipal Hospital,Weihai 264200,Shandong Province,China;Department of Ophthalmology,Provincial Hospital Affiliated to Shandong University,Jinan 250021,Shandong Province,China)

机构地区：[1]中国山东省威海市立医院眼科,264200 [2]山东大学附属省立医院眼科,中国山东省济南市250021

出　　处：《国际眼科杂志》2018年第1期195-197,共3页International Eye Science

摘　　要：目的:探讨单侧内直肌截除术治疗儿童残余性和复发性外斜视的有效性及安全性,评价其在不同外斜视类型及不同初次手术方式应用的差异性。方法:回顾性病例系列研究。收集2009-01/2013-02在山东大学附属山东省立医院行单侧内直肌截除术治疗的残余性和复发性外斜视连续性病例48例48眼,观察术后第1d,6wk以及末次随访(术后6~32mo)时患儿眼位、眼位非共同性、融合功能及立体视锐度情况。结果:术后第1d手术正位率为83%(40/48),欠矫率为4%(2/48),过矫率为13%(6/48);术后第6wk手术正位率为81%(39/48),欠矫率为13%(6/48),过矫率为6%(3/48);末次随访时正位率为75%(36/48),欠矫率为25%(12/48),无1例过矫。不同初次手术方式和不同外斜视类型患儿末次随访时手术正位率的差异均无统计学意义(P=0.168、0.50)。术后所有病例均未出现眼球运动非共同性和眼球外转受限。结论:单侧内直肌截除术是治疗儿童残余性和复发性外斜视的安全有效术式。AIM:To investigate the efficacy of unilateral medial rectus resection in children with residual and recurrent exotropia and analyze the influence of difference types of strabismus and methods of primary surgery on the surgical outcome.METHODS:This investigation was a retrospective case series study that examined data from48pediatric patients(48eyes)who underwent unilateral medial rectus resection between January2009and February2013for residual and recurrent exotropia.We surveyed the outcome of eye alignment,lateral incomitance,fusion function,stereoacuity in children at1d,6wk and at last follow-up of6-32(mean11.99±7.06)mo after the surgery.RESULTS:At1d after the surgery,the rate of surgical success was83%(40/48),and the rate of undercorrection and overcorrection was4%(2/48)and13%(6/48),respectively.At6wk after the surgery,the rate of surgical success was81%(39/48),and the rate of undercorrection and overcorrection was13%(6/48)and6%(3/48),respectively.At the final follow-up of6-32(mean11.99±7.06)mo,the surgical success rate was75%(36/48),and the rate of undercorrection was25%(12/48).No patient exhibited overcorrection.There were no significant differences in the surgical success rate either among pediatric patients who had previously undergone different types of surgery or among patients who had been diagnosed with different types of exotropia(P=0.168and P=0.50,respectively).No patients presented with lateral incomitance or limited ocular motility.CONCLUSION:Unilateral medial rectus resection is a safe and effective surgical approach for treating in children with residual and recurrent exotropia.In addition,it may achieve the same surgical effectiveness regardless of the patients'previous surgical procedures or types of exotropia.

关 键 词：单侧内直肌截除术 外斜视 复发性手术 

分 类 号：R779.6[医药卫生—眼科]