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Войти в исследования Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) · 2026
Slanted versus conventional bilateral lateral rectus recession in children with convergence insufficiency intermittent exotropia: A multicentre, randomized trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Yao Jing, Wang Xiying, Yang Chenhao, Dong Lingyan, Xu Jiangtao, Ren Xiaojun, Jiang Chao, Zhu Wenqing, Zhou Rongmei, Feng Tienan, Hong Jie, Liu Hu, Zhou Lianhong, Wang Lihua, Li Junhong, Kang Xiaoli, Li Yueping, Zhang Wei, Zhao Kanxing, Zhao Chen, Chinese Pediatric Eye Disease Investigator Group
Аннотация
PURPOSE: To assess the efficacy of slanted bilateral lateral rectus recession (S-BLR) versus conventional bilateral lateral rectus recession (C-BLR) in children with convergence insufficiency intermittent exotropia (CI-IXT).
DESIGN: Multicentre, randomized controlled trial.
METHODS: Chinese children aged 5-12 years with CI-IXT were consecutively enrolled, and randomly assigned (1:1) to receive either S-BLR or C-BLR. The primary outcome was the 12-month overall success rate, defined as a postoperative residual deviation between 10Δ of exodeviation and 5Δ of esodeviation with near-distance disparity (NDD) < 10Δ.
RESULTS: A total of 200 participants were enrolled, and 188 (97 S-BLR, 91 C-BLR) were finally included in the modified intention-to-treat analysis. The median age was 8 (6-9) years, and 90 (48 %) were male. The 12-month overall success rates did not differ significantly between the groups (group difference 8 %, P = 0.27, adjusted P = 0.36). However, S-BLR exhibited a lower rate of near undercorrection (group difference -12 %, P = 0.06), more collapse of NDD (-2.00Δ, P = 0.001), less residual near exodeviation (-4.00Δ, P < 0.001), better control of near exodeviation (0.00, P = 0.01), and a higher proportion of improved stereoacuity (12 %, P = 0.06). Subgroup analysis for NDD≤ 15Δ revealed a higher success rate of near deviation (86 % versus 69 %, P = 0.02), and a lower rate of near undercorrection (13 % versus 30 %, P = 0.01) in S-BLR group. Aside from undercorrection and overcorrection, no additional long-term suboptimal surgical outcomes were observed.
CONCLUSIONS: Although the overall success rates did not differ, S-BLR showed potential superiority at near in children with CI-IXT. More participants with NDD> 15Δ, and a longer follow-up are needed to validate these findings.
DESIGN: Multicentre, randomized controlled trial.
METHODS: Chinese children aged 5-12 years with CI-IXT were consecutively enrolled, and randomly assigned (1:1) to receive either S-BLR or C-BLR. The primary outcome was the 12-month overall success rate, defined as a postoperative residual deviation between 10Δ of exodeviation and 5Δ of esodeviation with near-distance disparity (NDD) < 10Δ.
RESULTS: A total of 200 participants were enrolled, and 188 (97 S-BLR, 91 C-BLR) were finally included in the modified intention-to-treat analysis. The median age was 8 (6-9) years, and 90 (48 %) were male. The 12-month overall success rates did not differ significantly between the groups (group difference 8 %, P = 0.27, adjusted P = 0.36). However, S-BLR exhibited a lower rate of near undercorrection (group difference -12 %, P = 0.06), more collapse of NDD (-2.00Δ, P = 0.001), less residual near exodeviation (-4.00Δ, P < 0.001), better control of near exodeviation (0.00, P = 0.01), and a higher proportion of improved stereoacuity (12 %, P = 0.06). Subgroup analysis for NDD≤ 15Δ revealed a higher success rate of near deviation (86 % versus 69 %, P = 0.02), and a lower rate of near undercorrection (13 % versus 30 %, P = 0.01) in S-BLR group. Aside from undercorrection and overcorrection, no additional long-term suboptimal surgical outcomes were observed.
CONCLUSIONS: Although the overall success rates did not differ, S-BLR showed potential superiority at near in children with CI-IXT. More participants with NDD> 15Δ, and a longer follow-up are needed to validate these findings.