目的:本研究的目的是比较水平肌移位和下斜肌弱化联合水平手术治疗V型外斜视(XT)的效果,并确定最成功的方法。
方法:在我们的回顾性研究中,将52例因V型XT行水平手术并随访至少6个月的患者分为两组。第1组(n=26)包括接受直肌垂直转位联合水平手术的患者,第2组(n=26)包括接受下斜肌弱化联合水平手术的患者。比较两组手术前后的视力,屈光不正,偏差角,模式斜视,聚变,立体视觉,矫正过度/不足和手术成功。
结果:两组在年龄方面没有差异,随访期,视敏度,屈光不正,融合或立体视。在1-6个月的随访中,第2组的水平偏差量较小。两组在模式崩溃方面没有差异;然而,第2组术后模式数量较低。两组在矫正过度方面相似;然而,第1组的矫正不足率较高。第2组手术成功率较高。
结论:在手术成功率和术后模式数量方面,发现由于V型XT引起的下斜肌力减弱联合水平手术优于水平肌肉的垂直移位。
OBJECTIVE: The objective of this study was to compare the effects of horizontal muscle transposition and inferior oblique weakening combined with horizontal surgery performed for V-pattern exotropia (XT) and to determine the most successful approach.
METHODS: In our retrospective study, 52 patients who underwent horizontal surgery due to V-pattern XT and were followed up for at least 6 months were divided into two groups. Group 1 (n = 26) consisted of patients who underwent vertical transposition of the rectus muscles combined with horizontal surgery, and group 2 (n = 26) consisted of patients who underwent inferior oblique weakening combined with horizontal surgery. The two groups were compared before and after surgery in terms of visual acuity, refractive errors, deviation angles, pattern strabismus, fusion, stereopsis, over/under correction and surgical success.
RESULTS: There was no difference between the two groups in terms of age, follow-up period, visual acuity, refractive errors, fusion or stereopsis. The amount of horizontal deviation was smaller in group 2 at the 1-6-month follow-ups. There was no difference between the two groups in terms of pattern collapse; however, the amount of pattern postoperatively was lower in group 2. The two groups were similar in terms of overcorrection; however, the undercorrection rate was higher in group 1. The surgical success rate was higher in group 2.
CONCLUSIONS: Inferior oblique weakening combined with horizontal surgery due to V-pattern XT was found to be superior to vertical transposition of the horizontal muscles in terms of surgical success and the amount of pattern postoperatively.