ABSTRACT
Objetivo: comparar los resultados motores y sensoriales de los pacientes con esotropía residual tratados con toxina botulínica A con el grupo que recibe cirugía convencional. Métodos: se realizó un estudio experimental (analítico), longitudinal y prospectivo en 27 pacientes que cumplieron con los criterios de inclusión: esotropía residual de 20 a 30 dioptrías independientemente de la edad. Se analizaron las siguientes variables: edad, sexo, diagnóstico previo, tipo de cirugía previa, número de inyección de toxina botulínica A empleada o cirugía realizada en la reintervención, efectos secundarios, complicaciones, ángulo de desviación, fusión y estereopsis preoperatorio y posoperatorio al año. Se consideró éxito quirúrgico la desviación postratamiento igual o menor de 10 dioptrías prismáticas. Resultados: el ángulo de desviación preoperatorio promedio del grupo toxina botulínica A fue de 24,0 ± 1,2 dioptrías y el de cirugía convencional de 25,8 ± 1,1, en oposición con el ángulo de desviación posoperatorio promedio, donde hallamos diferencias significativas (p= 0,003) entre ambos grupos (10,3 ± 1,1 versus 6,0 ± 0,80). El 64,3 por ciento, del grupo de toxina botulínica A y el 92,3 por ciento de cirugía convencional obtuvieron éxito quirúrgico. No se encontraron diferencias significativas ( p= 0,165). Se encontró ptosis palpebral como efecto secundario en el grupo toxina botulínica A y ninguna complicación en ningún grupo. El 44,4 por ciento de los pacientes obtuvo fusión postratamiento pero ninguno alcanzó estereopsis(AU) Conclusiones: en las esotropías residuales de 20 a 30 dioptrías prismáticas tratadas con toxina botulínica se obtienen resultados motores y sensoriales similares al del grupo de cirugía convencional
Objective: to compare the motor and sensory results of patients with residual esotropia, who were treated with botulinum toxin A, and of a group undergoing conventional surgery. Methods: a prospective, longitudinal and experimental (analytical) study was conducted in 27 patients who fulfilled the inclusion criteria: residual esotropia from 20 to 30 dioptries independently of the age. The following variables were analyzed: age, sex, previous diagnosis, type of previous surgery, number of injection of botulinum toxin A applied or type of surgery performed in the reintervención, secondary effects, complications, deviation angle, coalition and preoperative and postoperative estereopsis to the year. It was considered surgical success the deviation same post-treatment or smaller than 10 prismatic dioptries. Results: the angle of preoperative deviation average of the group toxin botulínica A was of 24,0 ± 1,2 dioptres and the one of conventional surgery of 25,8 ± 1,1, in opposition with the angle of posoperative deviation average, where find significant differences ( p= 0,003) between both groups (10,3 ± 1,1 versus 6,0 ± 0,80). The 64,3 percent of the group of toxin botulínica A and the 92,3 percent of conventional surgery obtained surgical success. Significant differences were not find (p= 0,165). Palpebral ptosis was found as secondary effect in the group toxin botulínica A, and any complication in any group. The 44,4 percent of the patients obtained post-treatment fusion but any reached to estereopsis(AU) Conclusions: the residual esotropias of 20 to 30 prismatic dioptres treated with toxin botulínica shows resulted engines and sensory similar to the group of conventional surgery
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Blepharoptosis , Botulinum Toxins, Type A/therapeutic use , Esotropia/surgery , Longitudinal Studies , Prospective StudiesABSTRACT
Unilateral or bilateral lateral rectus resection1-5 is commonly performed for the correction of residual esotropia, but few results have been reported. Twenty-eight patients with residual esotropia underwent bilateral lateral rectus (BLR) resection. Six months after operation (n = 25), there were 17 (68%) successful cases, 7 (28%) cases of undercorrection, and 1 (4%) case of overcorrection. The success rate at the 24th postoperative month (n = 11) was 72.7%. The success rate for cases of infantile esotropia (n = 18) was higher than that for acquired esotropia (n = 7) at the 6th postoperative month (p = 0.156). The results were not significantly affected by the presence of other deviations (p = 0.387), the performance of other surgery (p = 0.393), the presence of amblyopia (p = 1.00), or the amount of residual esotropia (p = 0.604). Performance of BLR resection in patients with residual esotropia after bilateral medial rectus (BMR) recession is considered appropriate due to its high success rate and provision of a stable alignment during two-year follow up.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Comparative Study , Esotropia/surgery , Follow-Up Studies , Oculomotor Muscles/surgery , Ophthalmologic Surgical Procedures/methods , Postoperative Complications , Reoperation , Retrospective Studies , Treatment Outcome , Visual AcuityABSTRACT
PURPOSE: To investigate the surgical outcome of both lateral rectus resection in the treatment of residual esotropia with previous both medial rectus recession METHODS: The medical record of 30 patients who had underwent both lateral rectus resection from 1996 to 2001 for residual esotropia occurred after bilateral medial rectus recession and who had followed up for more than one year, were analysed retrospectively. Successful outcome was defined as esotropia 0.05), but it was not significant statistically. Postoperative angle of deviation in group II was increased from 8.1+/-4.6PD at postoperative 1 day to 13.8+/-7.9PD at postoperative 1 year (p<0.001). CONCLUSIONS: Both lateral rectus resection is an effective method in the treatment of residual esotropia less than 40 PD.
Subject(s)
Female , Humans , Male , Esotropia , Exotropia , Medical Records , Reoperation , Retrospective StudiesABSTRACT
We studied the success rate of bilateral 7mm medical rectus recession for 24 patients with large angle congenital esotropia through long-term follow-up. The success rate was 100%(24/24) at immediate postoperative period, 83.3%(20/24) at postoperative 6 months, 79.1%(19/24) at postoperative 1 year, 64.1%(9/14) at postoperative 18 months and 54.5% (6/11) at postoperative 2 years. Residual esotropia rate was 0%(0/24) at immediate postoperative period, 16.6%(4/24) at postoperative 6 months, 16..6%(4/24) at postoperative 1 year, 14.2%(2/14) at postoperative 18 months and 18.1%(2/11) at postoperative 2 years. Consecutive exotropia rate was 0%(0/24) at immediate postoperative period, 0%(0/24) at postoperative 6 months, 4.1 %(1/24) at postoperative 1 year, 21.4%(3/14) at postoperative 18 months and 27.2%(3/11) at postoperative 2 years. Residual esotropia may develop before 6 months and consecutive exotropia after 1 year postoperatively.