【摘要】 目的 收集因共同性内斜视术后继发性外斜视患者,分别行单侧内直肌前徙和外直肌后徙术术后成功率,评估眼外肌的手术剂量-效应关系。方法 回顾性收集分析因共同性内斜视行单侧或双侧内直肌后徙手术后出现的小角度继发性外斜视34例,分别行单侧内直肌前徙术(Ⅰ组)和单侧外直肌后徙术(Ⅱ组),术后最少随访6个月。结果 23例(23/34,67.65%)行内直肌前徙术(I组),11例(11/34,32.35%)行外直肌后徙术(Ⅱ组),Ⅰ组术前平均近远斜视角分别为23.26±5.96PD和23.26±5.96PD,Ⅱ组术前平均近远斜视角分别为20.45±4.16PD和22.73±5.18PD。Ⅰ组成功率为73.91%(17/23),Ⅱ组为63.64%(7/11)(P>0.05)。Ⅰ组剂量效应关系的平均值为3.89±0.71PD/mm,Ⅱ组为2.70±0.52 PD/mm。结论 在小度数偏斜角继发性外斜视组中内直肌前徙术和外直肌后徙术均能有效矫正偏斜。内直肌前徙术比外直肌后徙术在继发性外斜视有更高的剂量-效应关系,内直肌前徙术在术后长期管理中更有优势。更多还原

【Abstract】 Objective To evaluate the surgical dose-effect relationship between patients with small-angle oblique who underwent unilateral medial rectus advancement and lateral rectus posterior migration in patients with secondary exotropia due to common esotropia after postoperative transfer of lateral rectus muscles,respectively.Methods A retrospective analysis was performed for 34 patients with small-angle secondary exotropia who underwent unilateral or bilateral medialrectus regression surgery for common esotropia.Patients should be followed up for at least 6 months after surgery.Results 23(23/34,67.65%) performed medial rectus anterior migration(group Ⅰ),11(11/34,32.35%) routine rectus regression surgery(Group Ⅱ).The average preoperative near and distant angles in group Ⅰ were 23.26±5.96 PD and 23.26±5.96 PD,respectively,and in group Ⅱ were 20.45±4.16 PD and 22.73±5.18 PD,respectively.At the end of follow-up,the orthophoria rate of the Ⅰ group was 73.91%(17/23) and that of the Ⅱ group was 63.64%(7/11)(P>0.05).The mean of the dose-response relationship was 3.89±0.71 PD/mm in Group Ⅰ compared to 2.70±0.52 PD/mm in GroupⅡ.Conclusions In the group of exotropia secondary to small degree deviation angle,medial rectus anterior migration and lateral rectus posterior migration can effectively correct the deviation,and there is no significant difference in statistics.Medial rectus advancement has a higher dose-response relationship than lateral rectus recession in secondary exotropia,and anterior medial rectus migration has advantages in long-term postoperative management.更多还原