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The relationship between abduction deficit and reoperation among patients with infantile esotropia

International Journal of Ophthalmology(English edition) 2018年第3期11卷 478-483页

作者： Zhale Rajavi Hamideh Sabbaghi Pooya Torkian Narges Behradfar Mehdi Yaseri Mohadeseh Feizi Mohammad Faghihi Kourosh Sheibani Ophthalmic Epidemiology Research Center Shahid Beheshti University of Medical Sciences Department of Ophthalmology School of Medicine Shahid Beheshti University of Medical Sciences Ophthalmic Research Center Shahid Beheshti University of Medical Sciences Department of Optometry School of Rehabilitation Shahid Beheshti University of Medical Sciences School of Medicine Shahid Beheshti University of Medical Sciences Department of Epidemiology and Biostatistics Tehran University of Medical Sciences Torfeh Eye Hospital Shahid Beheshti University of Medical Sciences Basir Eye Health Research Center Basir Eye Clinic

AIM： To determine the relationship between abduction deficit and reoperation among patients with infantile esotropia （IET）. METHODS： The records of 216 patients （432 eyes） with lET who underwent surgery, from 2010 to 2015 were studied. Patients with lET whose deviation appeared before 6mo of age and had stable preoperative deviation in two examinations with at least 2wk apart and a minimum 3too postoperative follow up were included. Cases with early onset accommodative esotropia, congenital cataract, retinopathy of prematurity （ROP）, manifest nystagmus, fundus lesions, neurologic and ophthalmic anomalies, 6th nerve palsy and Duane＇s syndrome were excluded. Preoperative abduction deficit was considered from -1 to -3 grading scale. Three months after surgery, children were classified into no-need reoperation [deviation〈15 prism diopters （PD）], and need-reoperation groups （deviaUon〉15 PD）. RESULTS： In this retrospective study, 117 female and 99 male patients with the mean surgical age of 4.7±6.4y were included. Reoperation rate was 33.3% and 16.0% in lET patients with and without abduction deficit, respectively in patients who had a history of late surgery. Abduction deficit increased the odds of reoperation by 82% [OR=1.82, 95% confidence interval （CI） =1.05 to 3.19, P=0.003] in patients who had a history of late surgery （〉2 years old, P=0.021）. Abduction deficit was improved significantly after operation （P〈0.001）. CONCLUSION： Based on our results, abduction deficit can be considered as a risk factor of reoperation in lET patients who are operated at the age of more than 2y.

关键词： infantile esotropia abduction deficit reoperation rate

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Relation between preoperative hyperopia and surgical outcome in infantile esotropia

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International Journal of Ophthalmology(English edition) 2018年第12期11卷 1963-1967页

作者： Haeng Jin Lee Jeong-Ah Kim Seong-Joon Kim Young Suk Yu Department of Ophthalmology Seoul National University College of Medicine Seoul Artificial Eye Center Seoul National University Hospital Clinical Research Institute

AIM: To evaluate the relation between preoperative hyperopia and surgical outcomes of infantile esotropia in patients younger than 24 months of ***: Medical records of patients who underwent bilateral medial rectus muscle recession for infantile esotropia between November 1, 2002 and December 1, 2011 were retrospectively reviewed. Patients were divided into two groups according to the degree of preoperative hyperopia. Group I had less than +3.0 diopter(D) of hyperopia and group II had between +3.0 and +5.0 D of hyperopia. Postoperative alignments were evaluated 1 wk, 3, 6 mo, and 1 y after surgery. Following the 1-year postoperative visit, patients were monitored yearly. Relationships between preoperative factors including hyperopia and postoperative outcomes were evaluated. RESULTS: Forty-six patients were included, with 33 patients in group I and 13 patients in group II. The preoperative mean refractive error was +0.88 D in group I and +3.45 D in group II. Surgical outcomes were not significantly different between groups at any postoperative time point examined. Cumulative probability of surgical success, prevalence of inferior oblique overaction, dissociated vertical deviation, and re-operation rate were not significantly different between ***: Preoperative moderate hyperopia(less than +5.0 D) did not affect the surgical outcome of infantile esotropia. Therefore, the surgical correction of esotropia should be considered when the angle of esodeviation is unchanged following hyperopia correction, even in children with moderate hyperopia.

关键词： infantile esotropia hyperopia medial rectus muscle recession

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