American journal of ophthalmology · 2025
Surgical Dosing for Correction of Consecutive Exotropia.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Meng Qingyu, Parunakian Emanuil, Yehezkeli Veronika, Demer Joseph L
Аннотация
PURPOSE: Because surgical tables have not previously been available for consecutive exotropia, this study aimed to determine the appropriate surgical dosing for medial rectus (MR) advancement in this condition.
DESIGN: Retrospective case series.
METHODS: Data were reviewed for patients with consecutive exotropia who underwent MR advancement with or without lateral rectus (LR) recession.
RESULTS: A total of 44 patients were included averaging 35 ± 20 (stamdard deviation ) years of age. Mean preoperative exotropia was 29 ± 15∆ at distance and 33 ± 19∆ at near. Thirty-four patients underwent unilateral or bilateral MR advancement, and 10 patients underwent MR advancement combined with LR recession. For the MR advancement group, mean advancement was 4.9 ± 1.4 mm. At the last follow-up visit, exotropia at distance was reduced from 26 ± 12∆ to 7 ± 11∆. For the MR advancement + LR recession group, mean MR advancement was 6.2 ± 2.0 mm, and the mean total surgical dose, including LR recession, was 14.6 ± 4.7 mm. Overall, distance exotropia at last follow-up was surgically reduced from 39 ± 18∆ to 9 ± 14∆. Exodrift from initial to final follow-up was 6.6∆ for MR advancement alone and 7.5∆ for MR advancement + LR recession. Regression analysis of surgical dose-response suggests that each MR advancement should be augmented by 2 mm more than Parks' general surgical recommendation for treating exotropia by MR resection.
CONCLUSIONS: Augmentation of MR advancement may improve the correction of consecutive exotropia and is effective while affording opportunity to explore the MR muscle.
DESIGN: Retrospective case series.
METHODS: Data were reviewed for patients with consecutive exotropia who underwent MR advancement with or without lateral rectus (LR) recession.
RESULTS: A total of 44 patients were included averaging 35 ± 20 (stamdard deviation ) years of age. Mean preoperative exotropia was 29 ± 15∆ at distance and 33 ± 19∆ at near. Thirty-four patients underwent unilateral or bilateral MR advancement, and 10 patients underwent MR advancement combined with LR recession. For the MR advancement group, mean advancement was 4.9 ± 1.4 mm. At the last follow-up visit, exotropia at distance was reduced from 26 ± 12∆ to 7 ± 11∆. For the MR advancement + LR recession group, mean MR advancement was 6.2 ± 2.0 mm, and the mean total surgical dose, including LR recession, was 14.6 ± 4.7 mm. Overall, distance exotropia at last follow-up was surgically reduced from 39 ± 18∆ to 9 ± 14∆. Exodrift from initial to final follow-up was 6.6∆ for MR advancement alone and 7.5∆ for MR advancement + LR recession. Regression analysis of surgical dose-response suggests that each MR advancement should be augmented by 2 mm more than Parks' general surgical recommendation for treating exotropia by MR resection.
CONCLUSIONS: Augmentation of MR advancement may improve the correction of consecutive exotropia and is effective while affording opportunity to explore the MR muscle.