Aaron M. Miller MD , Jonathan M. Holmes BM, BCh , Rui Wu MS , Raymond T. Kraker MSPH , Eric R. Crouch MD , Katherine A. Lee MD , Monte A. Del Monte MD , Justin D. Marsh MD , Courtney L. Kraus MD , David K. Wallace MD, MPH , Jeffrey D. Colburn MD , Pavlina S. Kemp MD , Susan A. Cotter OD, MS , Pediatric Eye Disease Investigator Group (PEDIG)
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引用次数: 0
Abstract
We evaluated whether doses of bilateral medial rectus recessions greater than Parks’s tables yielded superior outcomes for adult-onset divergence insufficiency. Forty-two patients underwent bilateral medial rectus recessions. Dose was analyzed as the average total per muscle (surgery + suture adjustment if performed) and compared with the standard dose tables (based on preoperative distance esodeviation), as difference between dose performed and dose indicated by Parks’s tables. Each participant was classified as having received either Parks’s dose (within 0.5 mm) or a dose greater than Parks’s dose. Success was defined as “rarely” or “never” diplopia in distance straight-ahead gaze and reading. For patients classified as success, the mean difference between actual surgical dose performed and Parks’s dose was calculated. Success was 91% (29/32) in those receiving greater than Parks’s dose versus 67% (6/9) with Parks’s dose (difference = 24%; 95% CI, −5% to 60%). The mean surgical dose was 1.0 mm greater than Parks’s tables for the 35 successes (at 10 weeks) versus 0.7 mm greater for the 6 failures (difference = 0.4 mm; 95% CI, −0.2 to 0.9). For medial rectus recessions in adult-onset divergence insufficiency-type esotropia, a surgical dose 1 mm greater than Parks’s tables, for each muscle, is a reasonable strategy.
期刊介绍:
Journal of AAPOS presents expert information on children''s eye diseases and on strabismus as it affects all age groups. Major articles by leading experts in the field cover clinical and investigative studies, treatments, case reports, surgical techniques, descriptions of instrumentation, current concept reviews, and new diagnostic techniques. The Journal is the official publication of the American Association for Pediatric Ophthalmology and Strabismus.