Acquired distance esotropia associated with myopia.
Acquired distance esotropia associated with myopia.
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DOI：
10.1080/09273970490489694
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发表时间：
2004-09-01
期刊：
影响因子：
0.9
通讯作者：
Lee, John
中科院分区：
文献类型：
--
作者：
Webb, Hilary;Lee, John
背景技术背景：Von Graefe（1864）（1）和Bielschowsky（1922）（2）描述了与中度近视相关的获得性进行性内斜视，通常远侧角度大于近视。方法：回顾性分析26例高度近视患者的临床资料，其中女性14例，男性12例。首次就诊时的年龄范围为37-74岁，平均55.5岁。近视度数为-0.75 ~-10.00，平均每眼-5.50。18例患者主要戴眼镜，8例主要戴隐形眼镜。均主诉水平复视。17例（65%）已与棱镜治疗的功率逐渐增加。结果：6例患者（23%）继续与棱镜，虽然手术已在3例提供。7名患者（27%）的一个内直肌肉毒杆菌毒素。在两个病例中，这被证明是成功的维持治疗，其余五个病例继续进行手术。17例（65%）接受了手术（主要是单侧内直肌后退和外直肌切除），复视缓解，棱镜丢弃。3名患者在10-12年后需要进一步手术治疗复发，另一名患者在11年后使用棱镜治疗复发。一个病人遭受了早期复发6个月后手术，并有他的神经系统work-up repeated.CONCLUSION：这种不寻常的子类型的斜视是一个良性的实体，反应良好的棱镜矫正或手术的情况下，谁愿意戴隐形眼镜或其棱镜变得不方便强。
BACKGROUND: Von Graefe (1864)(1) and Bielschowsky (1922)(2) described acquired progressive esotropia, with typically a larger angle for distance than near, associated with moderate myopia. This is unlike the esotropia seen in patients with high myopia.METHODS: We reviewed our patient records, finding 26 cases: 14 were female, 12 male. Age range at first presentation was 37-74 with a mean of 55.5. The myopia was from -0.75 to -10.00, with a mean of -5.50 in each eye. Eighteen patients mostly wore glasses, eight mainly wore contact lenses. All complained of horizontal diplopia. Seventeen (65%) had been treated with prisms with a gradual increase in power.RESULTS: Six patients (23%) continued with prisms although surgery has been offered in three cases. Seven patients (27%) had botulinum toxin to one medial rectus muscle. In two cases this proved to be successful maintenance therapy, the remaining five have gone on to have surgery. Seventeen (65%) have undergone surgery (mainly unilateral medial rectus recession and lateral rectus resection) with relief of diplopia and discarding of prisms. Three patients required further surgery for a recurrence after 10-12 years and another is using prisms for a recurrence after 11 years. One patient has suffered an early recurrence 6 months following surgery and is having his neurological work-up repeated.CONCLUSION: This unusual sub-type of strabismus is a benign entity, which responds well to prism correction or surgery in cases who wish to wear contact lenses or whose prisms become inconveniently strong.