外直肌悬吊术与外直肌后徙术治疗共同性外斜视的疗效比较

Lateral rectus hang-back recession versus conventional recession for exotropia

目的探讨外直肌悬吊术与传统后徙术治疗共同性外斜视的疗效。方法收集2007年1月至2013年1月深圳市南山区妇幼保健院和广东医学院附属南山医院眼科门诊收治的30例(60只眼)共同性外斜视患者的临床资料。按照入院时间将2007年1月至2010年1月就诊的患者作为A组,将2010年2月至2013年1月就诊的患者作为B组,每组各15例(30只眼)患者。A组采用常规外直肌后徙术进行治疗,B组采用外直肌悬吊术进行治疗,术后3个月对两组患者进行随访。采用χ2检验的方法比较两组患者手术的成功率,采用t检验比较两组患者的斜视度。结果 A组患者术前平均斜视度为(35.8±9.81)△,B组患者术前平均斜视度为(36.6±10.62)△,术前两组患者斜视度比较,差异无统计学意义(t=0.21,P>0.05)。术后3个月A组患者平均斜视度为(6.8±1.81)△,B组患者平均斜视度为(7.3±2.12)△,两组比较,差异无统计学意义(t=0.70,P>0.05)。A组患者术后成功率为86.7%(13/15),B组患者术后成功率为80.0%(12/15),差异无统计学意义(χ2=0.24,P>0.05)。结论外直肌悬吊术与外直肌后徙术治疗共同性外斜视的疗效相当,是一种安全、有效的手术方法。

ObjeCtive Comparatively evaluate the efficacy of lateral rectus hang-back and conventional recessions for exotropia. Methods A non-randomized sequential comparison study was designed in which 30 patients with exotropia who were treated, respectively, with conventional surgery （ n = 15） between January, 2007 and January,2010 and with lateral hang-back recession （n = 15 ） between February,2010 and January, 2013 in the Outpatient Eye Clinics of Nanshan Maternity and Children＇s Hospital and Guangdong Medical College-Affiliated Nanshan Hospital. In both treatment groups, patients were followed up for 3 months. At the end of the follow-up, the success rate and changes in the degree of strabismus before and after surgery were analyzed. Results The success rate was 86.7% （ 13/15 ） and 80.0% （12/15）, respectively, for the conventional procedure and lateral hang-back recession （P〉0.05）. The average degree of strabismus did not differ between the conventional recession and lateral hang-back recession procedures either before （35.8±9.81） vs （36.6±10.62） or after （6.8±1.81） vs （7.3±2.12） surgery （ P〉0.05 ）. Strabismus was effectively corrected by both procedures. Conclusion The lateral banghack surgical technique was as effective as the conventional rectus recession surgery for patients with exotropia.