[Three-muscle surgery for large angle esotropia].

4区医学 Q3 Medicine Ophthalmologe Pub Date : 2022-01-01 Epub Date: 2021-01-20 DOI:10.1007/s00347-020-01318-9

Michael Gräf, Julia Röhm, Heiko Wassill

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Abstract

Background: Bilateral medial rectus muscle recession with or without Cüppers' posterior fixation suture and recess and resect surgery are used to correct for large angle esotropia. There are only few reports on three muscle surgery (3MS). We analyzed the results of 3MS.

Patients and methods: Between June 2016 and May 2020, 61 patients received 3MS for esotropia ≥ 27° (50 PD) together with oblique muscle surgery, if needed. Angles of strabismus were measured by simultaneous prism and cover testing (SPCT) and alternating prism and cover testing (APCT) at 5 m and 0.3 m. Grading was around 0.51 mm/degree (at 5 m). Medium-term results of 57 patients were available.

Results: Medians and ranges (min-max) were: age, 6 years (3-56 years). Preoperative APCT, far 34° (27-45°), near 36° (27-50°). Amount of surgery, 17 mm (15-21 mm), oblique muscle recession in 21 cases. The APCT after 5 months (3-24 months), far 2° (-10-18), near 2° (-8-18). Success rates (absolute deviation ≤ 6° [10 PD]), APCT far 68%, near 67%, SPCT far 79%, near 74%. Exotropia > 6° occurred in 4 cases (7%) at far and 3 (5%) at near, esotropia > 6° in 14 cases (25%) at far and 16 (28%) at near.

Conclusion: The use of 3MS is a suitable first step procedure to correct for large angle esotropia.

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[三肌手术治疗大角内斜]。

背景：双侧内侧直肌后缩、Cüppers 后固定缝合或凹陷切除手术用于矫正大视角内斜视。关于三肌手术（3MS）的报道很少。我们对3MS的结果进行了分析：2016年6月至2020年5月期间，61名患者因内斜≥27°（50 PD）接受了三肌肉手术，必要时还接受了斜肌手术。通过同时棱镜和遮盖试验（SPCT）以及交替棱镜和遮盖试验（APCT）在 5 米和 0.3 米处测量斜视角度。分级约为 0.51 毫米/度（5 米处）。有 57 名患者的中期结果：中位数和范围（最小-最大）为：年龄，6 岁（3-56 岁）。术前 APCT，远 34°（27-45°），近 36°（27-50°）。手术量，17 毫米（15-21 毫米），斜方肌后退 21 例。5 个月后的 APCT（3-24 个月），远 2°（-10-18），近 2°（-8-18）。成功率（绝对偏差≤6° [10 PD]），APCT远68%，近67%，SPCT远79%，近74%。远期外斜大于 6° 的有 4 例（7%），近期有 3 例（5%）；远期内斜大于 6° 的有 14 例（25%），近期有 16 例（28%）：结论：使用 3MS 是矫正大角度内斜的第一步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmologe 医学-眼科学

CiteScore

1.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Der Ophthalmologe is an internationally recognized journal dealing with all aspects of ophthalmology. The journal serves both the scientific exchange and the continuing education of ophthalmologists. Freely submitted original papers allow the presentation of important clinical studies and serve scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Comprehensive reviews on a specific topical issue focus on providing evidenced based information on diagnostics and therapy. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.