肉毒杆菌毒素与手术治疗急性获得性共同性内斜视的疗效。

IF 4.1 1区 医学 Q1 OPHTHALMOLOGY
Xiangxiang Liu, Jiayu Chen, Jie Hao, Zhaojun Meng, Weibin Chen, Huijian Li, Jing Fu
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引用次数: 0

摘要

背景:急性获得性共同性内斜视(AACE)严重损害双眼视力,其发病率呈上升趋势。本研究旨在比较AACE患者斜视手术与注射肉毒杆菌毒素(BTX)的疗效,并探讨影响手术成功的因素。方法:对60例AACE患者进行前瞻性比较临床研究。27例患者行切口斜视手术(手术组),33例患者行BTX注射(化学神经支配组)。分别于治疗后1、3、6个月对患者进行随访。主要结果是治疗后6个月的成功率,定义为水平偏差在10棱镜屈光度(PD)或以下,确认双眼单视力。次要结局包括AACE复发的危险因素。结果:手术组27例,化学神经支配组33例。两组治疗后1个月和3个月的运动成功率无显著差异。然而,在治疗后6个月,手术组的运动成功率明显高于化学神经支配组(100% vs 69.7%, P < 0.05)。在化学神经支配组中,与屈光参差大于等于1度的患者相比,屈光参差小于1度(D)的患者表现出更高的运动成功率和更好的感觉结果,包括近视(84%,21/25)和近视(56%,14/25)(P = 0.044)。结论:BTX注射后3个月的成功率与手术后相似,但治疗后6个月的成功率较手术后低。接受BTX治疗的患者在术后第一个月内恢复了立体视觉,并在治疗后6个月内持续保持了这种功能。1d的屈光参差可能表明BTX注射作为AACE的首选治疗方案的适宜性。本研究已在中国临床试验注册中心注册(ChiCTR2100053717)。注册于2021年11月28日。https://www.chictr.org.cn/showprojEN.html?proj=140975)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of botulinum toxin and surgery in managing acute acquired comitant esotropia.

Background: Acute acquired comitant esotropia (AACE) can significantly impair binocular vision, and its prevalence is increasing. This study aims to compare the effectiveness of botulinum toxin (BTX) injections with strabismus surgery in patients diagnosed with AACE and to investigate the factors predicting success.

Methods: Sixty AACE patients were included in this prospective comparative clinical study. Twenty-seven patients underwent incisional strabismus surgery (surgery group) and 33 patients received BTX injection (chemodenervation group). Patients were followed up visit at 1, 3, and 6 months post-treatment. The primary outcome was the success rate at 6 months post-treatment, defined as a horizontal deviation of 10 prism diopters (PD) or less with confirmed binocular single vision. Secondary outcomes included risk factors for the recurrence of AACE.

Results: The present study included 27 patients in the surgery group and 33 in the chemodenervation group. No significant differences were observed in the motor success rate at 1 and 3 months post-treatment between the two groups. However, the surgery group had a significantly higher motor success rate compared to the chemodenervation group at 6 months post-treatment (100% vs. 69.7%, P < 0.001). The success rate of achieving stereopsis at near ≤ 100 arcsec in the chemodenervation group was significantly higher than in the surgery group at 1 month post-treatment (51.5% vs. 14.8%, P < 0.001). By the 6 months post-treatment, no significant differences were observed in sensory outcomes between the chemodenervation and surgery groups (P > 0.05 for all). In the chemodenervation group, patients with an anisometropia less than 1 dioptor (D)demonstrate significantly higher motor success rate, and better sensory outcomes, including stereopsis at near (84%, 21/25) and stereopsis at near ≤ 100 arcsec (56%, 14/25), compared to those with anisometropia of 1 D or more (P = 0.044).

Conclusion: The success rate after BTX injection was similar to that of surgery for 3 months but lower at 6 months post-treatment. Patients who received BTX showed restoration of stereopsis within the initial first postoperative month, with sustained preservation of this function across 6 months post-treatment. Anisometropia of 1 D may indicate suitability for BTX injection as a preferred treatment option for AACE. Trial registration This study was registered on the Chinese Clinical Trial Registry (ChiCTR2100053717. Registered 28 November 2021. https://www.chictr.org.cn/showprojEN.html?proj=140975 ).

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来源期刊
Eye and Vision
Eye and Vision OPHTHALMOLOGY-
CiteScore
8.60
自引率
2.40%
发文量
89
审稿时长
15 weeks
期刊介绍: Eye and Vision is an open access, peer-reviewed journal for ophthalmologists and visual science specialists. It welcomes research articles, reviews, methodologies, commentaries, case reports, perspectives and short reports encompassing all aspects of eye and vision. Topics of interest include but are not limited to: current developments of theoretical, experimental and clinical investigations in ophthalmology, optometry and vision science which focus on novel and high-impact findings on central issues pertaining to biology, pathophysiology and etiology of eye diseases as well as advances in diagnostic techniques, surgical treatment, instrument updates, the latest drug findings, results of clinical trials and research findings. It aims to provide ophthalmologists and visual science specialists with the latest developments in theoretical, experimental and clinical investigations in eye and vision.
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