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@#AIM: To observe the clinical curative effect of surgical correction of concomitant exotropia combined with weakening procedures in the treatment of children with complex strabismus. <p>METHODS: Totally 68 children(80 eyes)with complex strabismus who were admitted to the hospital from January 2015 to February 2017 were selected. All of them were treated by surgical correction of concomitant exotropia. The clinical diagnosis and treatment were retrospectively analyzed. They were divided into the combined group(<i>n</i>=30, 35 eyes)and the non-combined group(<i>n</i>=38, 45 eyes)according to the implementation of inferior oblique weakening procedures. The visual function, 5m exotropia deviation, degree of inferior oblique muscle overreaction and results of Titmus stereoscopic experiment were compared between the two groups before and after surgery. The postoperative curative effect of both groups was observed.<p>RESULTS: The proportions of patients with simultaneous vision, patients with certain fusion range, patients with distant stereoscopic vision and normal patients with near stereoscopic vision(40-60s)in both groups were significantly increased surgery at 6mo after surgery(<i>P</i><0.05), without significant differences between groups(<i>P</i>>0.05). The degree of inferior oblique muscle overreaction and 5m exotropia deviation in both groups were significantly improved at 6mo after surgery(<i>P</i><0.05), but there was no significant difference between groups(<i>P</i>>0.05). Follow-up of 1-3d, 1a after operation showed there were no significant differences between the two groups in the orthophoria rate, over-correction rate or under-correction rate(<i>P</i>>0.05).<p>CONCLUSION: In the treatment of children with complex strabismus by surgical correction of concomitant exotropia, the combined use of inferior oblique weakening procedures may not affect the correction effects of exotropia. When the surgery is designed, the impact of inferior oblique weakening procedures can be ignored.
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PURPOSE: To investigate the effect of unilateral inferior oblique weakening procedures on contralateral inferior oblique muscle functions and factors that may have an effect on contralateral inferior oblique muscle overaction (IOOA). METHODS: A retrospective chart review was conducted of medical records of 40 patients who underwent unilateral inferior oblique (IO) muscle weakening procedures from 2007 to 2011 and were observed during a follow-up period of more than 6 months. These patients were composed of primary IOOA (4 patients), secondary IOOA due to superior oblique muscle (SO) palsy (21 patients), secondary IOOA due to inferior rectus muscle palsy (1 patient), and dissociated vertical deviation (DVD) accompanied with IOOA (14 patients). Factors that may have an effect on contralateral IOOA after undergoing the operation were assessed. RESULTS: There were 7 patients (17.5%) who had over +2 IOOA after operation. IOOA on contralateral eye was increased from average of +0.00 to average of +0.66 +/- 0.14 in 6 months after operation (p < 0.01). There were no statistically significant differences between preoperative factors and functional changes in contralateral IO muscle. CONCLUSIONS: There were no statistical factors that may have an effect on contralateral IOOA but the possibility of masked SO palsy before performing unilateral IO weakening procedures should be considered. In patients who have unilateral DVD associated with IOOA or small hypertropia, the contralateral IOOA can be more definite after operation; thus caution should be taken before operation.
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Humans , Follow-Up Studies , Masks , Medical Records , Paralysis , Retrospective Studies , StrabismusABSTRACT
PURPOSE: To investigate whether combining inferior oblique weakening procedures with bilateral lateral rectus recession as a surgical approach to intermittent exotropia enhances postoperative horizontal angle of deviation over bilateral lateral rectus recession alone. METHODS: Patients were allocated to one of two surgical groups: a bilateral lateral rectus recession group (Group 1) or a bilateral lateral rectus recession with bilateral inferior oblique weakening group (Group 2). Group differences in the angle of distance deviation were evaluated preoperatively and at 3- and 12-months postoperatively. RESULTS: There were no significant differences in preoperative factors or angles of deviation between Group 1 (n = 98) and Group 2 (n = 77); no significant intergroup difference in the angle of deviation was observed at any postoperative time point (p > 0.05). CONCLUSIONS: Combined inferior oblique weakening procedures did not significantly influence the horizontal angle of deviation after surgery for intermittent exotropia. Accordingly, there is no need to revise the surgical amount of lateral rectus recession.