{"title":"治疗近视性斜视固定的改良西田手术。","authors":"","doi":"10.1016/j.jaapos.2024.103962","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the outcomes of a novel modification of the Nishida procedure with medial rectus recession (Nishida-MRc) for myopic strabismus fixus (MSF) and to compare this modified procedure with the half Jensen’s union with medial rectus recession (U-MRc).</p></div><div><h3>Methods</h3><p><span><span>The medical records of MSF patients who underwent </span>strabismus surgery at a single institution between January 2017 and June 2022 were retrospectively reviewed. The main outcome measures assessed were postoperative improvements in ocular alignment and motility. Surgical success was defined as horizontal and vertical deviations ≤15</span><sup>Δ</sup>.</p></div><div><h3>Results</h3><p>A total of 45 patients were included, of whom 39 had no previous strabismus surgery. All but 3 had follow-up ≥8 months. Nishida-MRc, with or without a traction suture (Ts), had a success rate (9/16 [56%]) higher, though not statistically significantly so, than U-MRc with or without Ts (11/29 [38%]). The Nishida-MRc group tended to have less frequent use of Ts (25% vs 52%; <em>P</em> = 0.076), and 94% of these patients had a deviation within 20<sup>Δ</sup>, compared with 59% for U-MRc (<em>P</em><span> = 0.012). In cases with esotropia of ≥123</span><sup>Δ</sup>, final residual esotropia in the Nishida-MRc without Ts (12.40<sup>Δ</sup> ± 8.30<sup>Δ</sup>) and U-MRc-Ts (19.75<sup>Δ</sup> ± 18.62<sup>Δ</sup>) groups was significantly lower (<em>P</em> = 0.019) than in the U-MRc without Ts group (63.40<sup>Δ</sup> ± 40.83<sup>Δ</sup>), and the average correction of esotropia was significantly greater (<em>P</em> = 0.014).</p></div><div><h3>Conclusions</h3><p>In our study cohort, Nishida-MRc produced a greater effect in the treatment of MSF than U-MRc.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A modified Nishida procedure for management of myopic strabismus fixus\",\"authors\":\"\",\"doi\":\"10.1016/j.jaapos.2024.103962\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>To evaluate the outcomes of a novel modification of the Nishida procedure with medial rectus recession (Nishida-MRc) for myopic strabismus fixus (MSF) and to compare this modified procedure with the half Jensen’s union with medial rectus recession (U-MRc).</p></div><div><h3>Methods</h3><p><span><span>The medical records of MSF patients who underwent </span>strabismus surgery at a single institution between January 2017 and June 2022 were retrospectively reviewed. The main outcome measures assessed were postoperative improvements in ocular alignment and motility. Surgical success was defined as horizontal and vertical deviations ≤15</span><sup>Δ</sup>.</p></div><div><h3>Results</h3><p>A total of 45 patients were included, of whom 39 had no previous strabismus surgery. All but 3 had follow-up ≥8 months. Nishida-MRc, with or without a traction suture (Ts), had a success rate (9/16 [56%]) higher, though not statistically significantly so, than U-MRc with or without Ts (11/29 [38%]). The Nishida-MRc group tended to have less frequent use of Ts (25% vs 52%; <em>P</em> = 0.076), and 94% of these patients had a deviation within 20<sup>Δ</sup>, compared with 59% for U-MRc (<em>P</em><span> = 0.012). In cases with esotropia of ≥123</span><sup>Δ</sup>, final residual esotropia in the Nishida-MRc without Ts (12.40<sup>Δ</sup> ± 8.30<sup>Δ</sup>) and U-MRc-Ts (19.75<sup>Δ</sup> ± 18.62<sup>Δ</sup>) groups was significantly lower (<em>P</em> = 0.019) than in the U-MRc without Ts group (63.40<sup>Δ</sup> ± 40.83<sup>Δ</sup>), and the average correction of esotropia was significantly greater (<em>P</em> = 0.014).</p></div><div><h3>Conclusions</h3><p>In our study cohort, Nishida-MRc produced a greater effect in the treatment of MSF than U-MRc.</p></div>\",\"PeriodicalId\":50261,\"journal\":{\"name\":\"Journal of Aapos\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Aapos\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1091853124002428\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Aapos","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1091853124002428","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
A modified Nishida procedure for management of myopic strabismus fixus
Purpose
To evaluate the outcomes of a novel modification of the Nishida procedure with medial rectus recession (Nishida-MRc) for myopic strabismus fixus (MSF) and to compare this modified procedure with the half Jensen’s union with medial rectus recession (U-MRc).
Methods
The medical records of MSF patients who underwent strabismus surgery at a single institution between January 2017 and June 2022 were retrospectively reviewed. The main outcome measures assessed were postoperative improvements in ocular alignment and motility. Surgical success was defined as horizontal and vertical deviations ≤15Δ.
Results
A total of 45 patients were included, of whom 39 had no previous strabismus surgery. All but 3 had follow-up ≥8 months. Nishida-MRc, with or without a traction suture (Ts), had a success rate (9/16 [56%]) higher, though not statistically significantly so, than U-MRc with or without Ts (11/29 [38%]). The Nishida-MRc group tended to have less frequent use of Ts (25% vs 52%; P = 0.076), and 94% of these patients had a deviation within 20Δ, compared with 59% for U-MRc (P = 0.012). In cases with esotropia of ≥123Δ, final residual esotropia in the Nishida-MRc without Ts (12.40Δ ± 8.30Δ) and U-MRc-Ts (19.75Δ ± 18.62Δ) groups was significantly lower (P = 0.019) than in the U-MRc without Ts group (63.40Δ ± 40.83Δ), and the average correction of esotropia was significantly greater (P = 0.014).
Conclusions
In our study cohort, Nishida-MRc produced a greater effect in the treatment of MSF than U-MRc.
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.