AIM: To compare the effectiveness of unilateral recession-resection(R&R) and bilateral/unilateral recession(BLR/ULR) for treatment of basic type of intermittent exotropia [IX(T)].METHODS: A comprehensive literatur...AIM: To compare the effectiveness of unilateral recession-resection(R&R) and bilateral/unilateral recession(BLR/ULR) for treatment of basic type of intermittent exotropia [IX(T)].METHODS: A comprehensive literature search was performed using PubMed, EMBASE, and the Cochrane Library, to identify randomized controlled trials and comparative studies regarding the effectiveness of R&R and BLR/ULR for IX(T). Based on which, a Meta-analysis was then performed in terms of long-term success rate, overcorrection rate, and recurrence rate.RESULTS: Nine studies in total satisfy the specified eligibility criteria. BLR is at disadvantage to R&R at a short-term follow-up [<2 y, OR 0.56(0.33-0.94) for success rate; OR 2.11(1.17, 3.81) for undercorrection rate]. However, BLR achieved a higher success rate [OR 2.49(1.61, 3.86)] and a lower undercorrection rate [OR 0.40(0.23, 0.71)], compared to that of R&R at a long-term followup(>2 y). There is no significant difference was found in overcorrection rate, regardless of the length of follow-up time [OR 0.85(0.41, 1.75)]. In the treatment for small-angle IX(T), the final outcome was significantly different between the groups, demonstrating a more successful alignment [OR 0.37(0.18, 0.74)] and a lower undercorrection [OR 3.50(1.28, 7.26)] in the R&R group than in the ULR group. While for moderate-angle IX(T)(20 PD-25 PD), the effectiveness of R&R and ULR is quite equivalent with similar success rate [OR 1.08(0.65, 1.79)] and undercorrection rate [OR 0.89(0.54, 1.48)]. CONCLUSION: As regard to the effect of BLR and R&R, R&R shows an advantage over BLR at short term. But, BLR is more effective in the long term for the basic typeIX(T) in children. R&R surgery should be a better choice for the treatment of small-angle IX(T) of ≤20 PD than ULR. However, both of ULR and R&R are recommended for moderate-angle IX(T) from 20 PD to 25 PD.展开更多
Purpose: The aim of this work was the evaluation of the effect of the limbus insertion distance (LID) of the lateral rectus on the surgical results of bilateral lateral rectus recession in intermittent exotropia (IXT)...Purpose: The aim of this work was the evaluation of the effect of the limbus insertion distance (LID) of the lateral rectus on the surgical results of bilateral lateral rectus recession in intermittent exotropia (IXT) in children and adults. Patients and Methods: This retrospective study included 76 patients. The patients were divided into two groups: group I (age 5 - 13 y), group II (>13 y). All the patients had basic type of intermittent exotropia (IXT) and all of them underwent bilateral lateral recessions according to the preoperative angle of deviation. Intraoperatively, the distance of limbus insertion was measured by surgical calipers. The dose response effect was calculated as the difference between the preoperative angle and postoperative angle divided by total amount of recession and cases were followed at 1 month, 3 months, 6 months and 12 months postoperative. Results: The mean LID in group I was (6.2 ± 0.61 mm) and (6.1 ± 0.55 mm) in group II. The mean dose response (MDR) at 1 year postoperative was (2.32 ± 0.25 mm) in group I and (2.26 ± 0.23) in group II. In patients with LID 6.25 mm who had larger mean dose response (2.52 ± 0.15). There was a significant positive correlation between the LR muscle LID and the dose-response effect. Conclusion: There is positive correlation between the LID of the LR muscle and the recession effect in bilateral lateral rectus recession in treatment of IXT.展开更多
In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus mu...In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus muscle recession were assigned into “with” and “without” intermuscular septum dissection study arms. The VPFH was measured at one-day before surgery and in two weeks and three months, postoperatively. Three months after surgery, significant increase of VPFH was observed in both groups （Paired t-test; P=0.005）. Also, less widening of VPFH was observed in “with intermuscular septum dissection” group （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： 0.48 mm vs 1.34 mm; ANCOVA test; P〈0.001）. However, such results were not observed two weeks post-operatively （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： -0.28 mm vs 0.28 mm; ANCOVA test; P=0.302）. Intermuscular septum dissection is recommended in lateral rectus muscle recession to partially prevent the undesirable increment of VPFH.展开更多
目的:探讨单侧内直肌后徙术与双侧内直肌后徙术对内斜视青少年视功能、斜视度及眼外肌、血清中胰岛素样生长因子-1(Insulin like growth factor 1,IGF-1)水平的影响。方法:选取笔者医院2020年1月-2022年1月收治的60例急性共同性内斜视(A...目的:探讨单侧内直肌后徙术与双侧内直肌后徙术对内斜视青少年视功能、斜视度及眼外肌、血清中胰岛素样生长因子-1(Insulin like growth factor 1,IGF-1)水平的影响。方法:选取笔者医院2020年1月-2022年1月收治的60例急性共同性内斜视(Adolescent patients with acute concomitant esotropia,AACE)青少年患者作为研究对象,按照随机数字表法分为观察组(30例,采用单侧内直肌后徙术治疗)和对照组(30例,采用双侧内直肌后徙术治疗),术后随访半年。观察两组患者治疗效果、Base-out恢复点参数、视功能、斜视度(N-D值),眼外肌、血清中IGF-1水平。结果:术后6个月,观察组患者正位率高于对照组患者,过矫率低于对照组患者(P<0.05)。术后6个月,观察组患者Base-out恢复点参数与Base-in(BI)恢复点与对照组比较差异无统计学意义(P>0.05)。术后6个月,观察组患者正常视近立体视比例高于对照组患者(P<0.05)。术后6个月,观察组患者斜视度与对照组比较差异无统计学意义(P>0.05)。术后6个月,观察组患者眼外肌、血清中IGF-1水平均高于对照组(P<0.05)。结论:单侧内直肌后徙术与双侧内直肌后徙术相比,其能提升内斜视青少年正位率,改善视功能情况,有利于临床推广。展开更多
基金Supported by Young Medical Talents Foundation of Jiangsu Province(No.QNRC2016080)
文摘AIM: To compare the effectiveness of unilateral recession-resection(R&R) and bilateral/unilateral recession(BLR/ULR) for treatment of basic type of intermittent exotropia [IX(T)].METHODS: A comprehensive literature search was performed using PubMed, EMBASE, and the Cochrane Library, to identify randomized controlled trials and comparative studies regarding the effectiveness of R&R and BLR/ULR for IX(T). Based on which, a Meta-analysis was then performed in terms of long-term success rate, overcorrection rate, and recurrence rate.RESULTS: Nine studies in total satisfy the specified eligibility criteria. BLR is at disadvantage to R&R at a short-term follow-up [<2 y, OR 0.56(0.33-0.94) for success rate; OR 2.11(1.17, 3.81) for undercorrection rate]. However, BLR achieved a higher success rate [OR 2.49(1.61, 3.86)] and a lower undercorrection rate [OR 0.40(0.23, 0.71)], compared to that of R&R at a long-term followup(>2 y). There is no significant difference was found in overcorrection rate, regardless of the length of follow-up time [OR 0.85(0.41, 1.75)]. In the treatment for small-angle IX(T), the final outcome was significantly different between the groups, demonstrating a more successful alignment [OR 0.37(0.18, 0.74)] and a lower undercorrection [OR 3.50(1.28, 7.26)] in the R&R group than in the ULR group. While for moderate-angle IX(T)(20 PD-25 PD), the effectiveness of R&R and ULR is quite equivalent with similar success rate [OR 1.08(0.65, 1.79)] and undercorrection rate [OR 0.89(0.54, 1.48)]. CONCLUSION: As regard to the effect of BLR and R&R, R&R shows an advantage over BLR at short term. But, BLR is more effective in the long term for the basic typeIX(T) in children. R&R surgery should be a better choice for the treatment of small-angle IX(T) of ≤20 PD than ULR. However, both of ULR and R&R are recommended for moderate-angle IX(T) from 20 PD to 25 PD.
文摘Purpose: The aim of this work was the evaluation of the effect of the limbus insertion distance (LID) of the lateral rectus on the surgical results of bilateral lateral rectus recession in intermittent exotropia (IXT) in children and adults. Patients and Methods: This retrospective study included 76 patients. The patients were divided into two groups: group I (age 5 - 13 y), group II (>13 y). All the patients had basic type of intermittent exotropia (IXT) and all of them underwent bilateral lateral recessions according to the preoperative angle of deviation. Intraoperatively, the distance of limbus insertion was measured by surgical calipers. The dose response effect was calculated as the difference between the preoperative angle and postoperative angle divided by total amount of recession and cases were followed at 1 month, 3 months, 6 months and 12 months postoperative. Results: The mean LID in group I was (6.2 ± 0.61 mm) and (6.1 ± 0.55 mm) in group II. The mean dose response (MDR) at 1 year postoperative was (2.32 ± 0.25 mm) in group I and (2.26 ± 0.23) in group II. In patients with LID 6.25 mm who had larger mean dose response (2.52 ± 0.15). There was a significant positive correlation between the LR muscle LID and the dose-response effect. Conclusion: There is positive correlation between the LID of the LR muscle and the recession effect in bilateral lateral rectus recession in treatment of IXT.
基金supported by Isfahan University of Medical Sciences
文摘In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus muscle recession were assigned into “with” and “without” intermuscular septum dissection study arms. The VPFH was measured at one-day before surgery and in two weeks and three months, postoperatively. Three months after surgery, significant increase of VPFH was observed in both groups （Paired t-test; P=0.005）. Also, less widening of VPFH was observed in “with intermuscular septum dissection” group （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： 0.48 mm vs 1.34 mm; ANCOVA test; P〈0.001）. However, such results were not observed two weeks post-operatively （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： -0.28 mm vs 0.28 mm; ANCOVA test; P=0.302）. Intermuscular septum dissection is recommended in lateral rectus muscle recession to partially prevent the undesirable increment of VPFH.
文摘目的:探讨单侧内直肌后徙术与双侧内直肌后徙术对内斜视青少年视功能、斜视度及眼外肌、血清中胰岛素样生长因子-1(Insulin like growth factor 1,IGF-1)水平的影响。方法:选取笔者医院2020年1月-2022年1月收治的60例急性共同性内斜视(Adolescent patients with acute concomitant esotropia,AACE)青少年患者作为研究对象,按照随机数字表法分为观察组(30例,采用单侧内直肌后徙术治疗)和对照组(30例,采用双侧内直肌后徙术治疗),术后随访半年。观察两组患者治疗效果、Base-out恢复点参数、视功能、斜视度(N-D值),眼外肌、血清中IGF-1水平。结果:术后6个月,观察组患者正位率高于对照组患者,过矫率低于对照组患者(P<0.05)。术后6个月,观察组患者Base-out恢复点参数与Base-in(BI)恢复点与对照组比较差异无统计学意义(P>0.05)。术后6个月,观察组患者正常视近立体视比例高于对照组患者(P<0.05)。术后6个月,观察组患者斜视度与对照组比较差异无统计学意义(P>0.05)。术后6个月,观察组患者眼外肌、血清中IGF-1水平均高于对照组(P<0.05)。结论:单侧内直肌后徙术与双侧内直肌后徙术相比,其能提升内斜视青少年正位率,改善视功能情况,有利于临床推广。
