Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
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Monocular Slanted Lateral Rectus Recession for Exotropia with Convergence Insufficiency

눈모음부족형 외사시에서 근경사부착술을 이용한 단안 외직근 후전술의 효과

Park, Jae-Sung;Lee, Soo-Jung;Roh, Young-Bae;Choi, Hee-Young
박재성;이수정;노영배;최희영

  • Published : 20070800
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Abstract

Purpose: To evaluate the efficacy of monocular slanted lateral rectus (LR) muscle recession for exotropia with convergence insufficiency. Methods: Twenty five patients with exotropia greater at near than at versus far distance by ≥10 prism diopters (PD), were divided into two groups: 15 patients who underwent monocular slanted LR recession (study group), and 10 patients who underwent monocular standard LR recession (control group). In the study group, the lower horn of the LR was recessed according to near deviation, the upper horn was recessed according to distance deviation. In the control group, monocular LR was recessed according to distance deviation. The postoperative ocular alignment at distance and near, and the difference between them, were measured and compared retrospectively. The criteria for successful outcome were postoperative residual deviation at near and distance, and the difference of 8 PD or less between the two. Results: The mean distance deviation showed a significant postoperative reduction in both groups (P<0.001, P<0.001). The mean near deviation showed a significant postoperative reduction in both groups (P<0.001, P<0.001). The mean difference between near and distance deviation showed a significant postoperative reduction only in the study group (P<0.001, P=0.175). Successful outcome was obtained in 13 our of 15 (86.7%) patients in the study group, in 2 out of 10 (20%) patients in the control group. None of the study patients had postoperative diplopia. Conclusions: Monocular slanted lateral rectus recession is effective in reducing both distant and near exodeviation and in collapsing the difference between distance and near deviation them at postoperative 4 months.

목적 : 눈모음부족형 외사시에서 근경사부착술(slanted surgery)을 이용하여 단안 외직근을 후전하고 수술 효과를 알아보고자 하였다. 대상과 방법 : 눈모음부족형 외사시 환자 중 근경사부착술을 이용한 단안 외직근 후전술을 시행한 15명(대상군)과 단안 외직근 후전술만 시행한 10명(대조군)을 비교하였다. 대상군은 외직근의 아래쪽은 근거리 사시각, 위쪽은 원거리 사시각을 기준으로 후전하였으며 대조군의 외직근은 원거리 사시각을 기준으로 후전하였다. 각 군에서 술 전과 술 후의 원거리, 근거리 사시각과 그 차이를 측정하여 후향적으로 연구하였다. 결과 : 원거리 사시각은 두 군 모두에서 술 후 매우 감소하였으며 (P<0.001, P<0.001), 근거리 사시각도 두 군 모두에서 감소하였다(P<0.001, P<0.001). 술 후 원거리와 근거리 사시각의 차이는 대상군에서만 의미 있는 감소를 보였다(P<0.001, P=0.175). 최종 경과관찰시 두 군에서 복시는 없었다. 결론 : 눈모음부족형 외사시에서 근경사부착술을 이용한 단안 외직근 후전술은 술 후 4개월째 근거리, 원거리 사시각과 그 차이를 줄이는데 효과적이었다.

Keywords

References

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