锚定与传统悬吊术治疗大面积内直肌后倾

I. Elsaadani, Taher K Eleiwa, Ahmed Khater
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引用次数: 0

摘要

目的比较锚定悬吊技术(HBT)与常规悬吊技术(HBT)在治疗大角度内斜视的双内侧直肌后退(BMR)中的手术效果。设计一项回顾性、非随机对照介入研究。参与者共94例内斜视患者,BMR≥6mm。方法根据BMR手术技术将患者随机分为(a)锚定HBT组和(b)常规HBT组。术后对近、远偏角进行量化。在6个月结束时,矫正斜视的10棱镜屈光度(PD)被认为是成功的结果。采用Kaplan-Meier分析确定两组患者的累积生存期。结果48例患者行常规HBT, 46例患者行锚定HBT。术前常规组近、远偏角均值分别为61.6、60.1 PD,锚定组为62.2、60.4 PD (P < 0.05)。术后6个月,常规组近、远偏角均值分别为-1.4、-3.4 PD,锚定组为1.2、0.1 PD (P=0.03)。常规组的成功率为76%,锚定组为87.5% (P=0.03)。Kaplan-Meier生存分析显示,常规HBT组6个月累计失败发生率显著高于锚定组(P=0.025, Log rank)。结论锚定HBT治疗脑mr大衰退的疗效优于常规HBT。
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Anchored versus conventional hang-back technique in large bimedial rectus recession
Purpose To compare surgical outcome of anchored hang-back technique (HBT) against conventional HBT in bimedial rectus-muscle recession (BMR) for large-angle esotropia. Design A retrospective nonrandomized comparative interventional study. Participants In total, 94 patients with esotropia and indicated for at least 6-mm BMR. Methods Patients were randomly assigned into two groups according to surgical technique of BMR: (a) anchored HBT and (b) conventional HBT. Postoperatively, angles of deviation were quantified for near and far. Alignment within 10-prism diopters (PD) of orthotropia was considered a successful result by the end of 6 months. Kaplan–Meier analysis was used to determine the cumulative survival in both groups. Results In total, 48 patients underwent conventional HBT and 46 patients in the anchored HBT. Preoperatively, mean angles of deviation for near and far were 61.6 and 60.1 PD in the conventional group, versus 62.2 and 60.4 PD in the anchored group, respectively (P>0.05). By the sixth postoperative month, the mean angles of deviation for near and far in the conventional group were –1.4 and –3.4 PD, versus 1.2 and 0.1 PD in the anchored group, respectively (P=0.03). Success rate was 76% in the conventional group, versus 87.5% in the anchored group (P=0.03). Kaplan–Meier survival analysis showed a significantly higher cumulative 6-month incidence of failure in the conventional HBT group than the anchored one (P=0.025, Log rank). Conclusion Anchored HBT showed a higher efficacy than conventional HBT in large BMR recession.
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