外直肌倾斜后徙术与外直肌后徙术治疗集合不足型外斜视的效果比较

doi:10.3760/cma.j.cn115909-20200407-00137

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Abstract Objective: To observe the surgical effects of slanted lateral rectus recession (S-LR) and lateral rectus recession (LR) on convergence insufficiency intermittent exotropia [CIX (T)]. Methods: In this retrospective study, surgery was performed by the same surgeon on 101 patients with CIX (T) in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to August 2019. They were divided into 2 groups: A bilateral slanted lateral rectus recession group (S-BLR group, 44 cases) and a bilateral lateral rectus recession group (BLR group, 57 cases). All patients were followed up for 3 months. The postoperative near deviation, distant deviation, and near-distant disparity (NDD) were measured and compared in this retrospective study. Data were analyzed using Mann-Whitney U test, χ2 test, t test. Results: Three months after surgery, the improvement of NDD was 8.0±3.3 PD in the S-BLR group and 6.1±4.0 PD in the BLR group (Z=-1.995, P=0.046). NDD improved more significantly in the S-BLR group than in the BLR group. The near deviation of the S-BLR group (-5.1±5.5 PD) significantly decreased compared with the BLR group (-8.3±5.8 PD) (Z=-2.882, P=0.004). There was no significant difference in distant deviation between the S-BLR group and LR group after 3 months. The success rates after 3 months of follow-up were 82% in the S-BLR group, which was a higher rate than 53% in the BLR group (χ2 =9.34, P=0.002). There was no significant difference between preoperative and postoperative fovea-disc angles and A and V patterns in the S-BLR group. Conclusions: In postoperative near deviation and NDD, S-LR patients improve more significantly than LR patients. S-LR does not cause A and V pattern strabismus or fundus rotation. S-LR patients have a better surgical outcome than LR patients with CIX (T).

Key words： convergence insufficiency intermittent exotropia near-distant disparity slanted lateral rectus recession

Received: 07 April 2020

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Corresponding Authors: Xiaoli Kang, Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China (Email: kangxiali@xinhuamed.com.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200407-00137 OR https://www.cjoovs.com/EN/Y2020/V22/I12/902

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