한눈 외직근후전술과 내직근절제술 후 재발한 간헐외사시에서 반대눈 외직근후전술 후 수술 결과
The Surgical Outcomes of Unilateral Lateral Rectus Recession in Recurrent Intermittent Exotropia after Unilateral Recession-Resection
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목적: 한눈 외직근후전술과 내직근절제술 후 재발하여 사시각이 18-20프리즘디옵터(prism diopter, PD)인 기본형 간헐외사시에서 반대눈 외직근후전술 후 수술 결과에 대해 알아보았다. 대상과 방법: 간헐외사시로 한눈 외직근후전술 및 내직근절제술을 받은 후 재발한 사시각이 18-20PD로 반대 눈에 외직근후전술을받은 환자(재수술군), 동일한 사시각을 갖는 간헐외사시로 일차로 한눈 외직근후전술을 받은 환자(일차수술군) 43명을 대상으로 의무기록을 후향적으로 분석하였다. 결과: 재수술군은 18명, 일차수술군은 25명이었다. 수술 나이, 성별, 굴절이상, 근거리 입체시, 술 전 사시각은 두 군 간에 유의한 차이가 없었다. 평균 경과관찰 기간은 재수술군에서 14.28 ± 14.98개월, 일차수술군에서 14.68 ± 12.15개월로 두 군 간에 차이가 없었으나, 술 후 최종 관찰 시 사시각은 재수술군에서 근거리 1.11 ± 3.89PD, 원거리 2.00 ± 4.70PD, 일차수술군에서 근거리 6.44 ± 5.26PD, 원거리 7.00 ± 5.77PD로, 재수술군에서 유의하게 작았다(p=0.000, p=0.004). 최종 관찰 시 수술 성공률은 각각 94.4%, 64.0%로 재수술군에서 유의하게 높았다(p=0.021). 결론: 한눈 외직근후전술 및 내직근절제술 후 재발한 18-20PD의 간헐외사시에서 시행한 반대눈외직근후전술의 장기적 수술 결과는 일차수술로 시행한 경우보다 의미 있게 좋았다.
Abstract
Purpose: To evaluate the surgical outcomes of unilateral lateral rectus (LR) recession on the contralateral eye for recurrent intermittent exotropia after unilateral recession-resection (R & R). Methods: A retrospective analysis of 43 patients was performed. The patients were classified into 2 groups, 18 patients who underwent unilateral LR recession for intermittent exotropia of 18 to 20 prism diopters (PD) after unilateral R & R (reoperation group) and 25 patients who had primary unilateral LR recession (primary operation group). Results: Significant differences in age, gender, refractive error, preoperative deviation, and near stereoacuity were not observed between the 2 groups (p > 0.05). The mean follow-up duration was 14.28 ± 14.98 months in the reoperation group and 14.68 ± 12.15 months in the primary operation group. Postoperative deviations were 1.11 ± 3.89 PD at near distance and 2.00 ± 4.70 PD at far distance in the reoperation group and 6.44 ± 5.26 PD at near distance and 7.00 ± 5.77 PD at far distance in the primary operation group on the final follow-up (p = 0.000, p = 0.004). The final surgical successful rates were 94.4% in the reoperation group and 64.0% in the primary group (p = 0.021). Conclusions: The long-term surgical results of unilateral LR recession on the contralateral eye was better in patients with recurrent intermittent exotropia of 18 to 20 PD after unilateral R & R than patients who had primary unilateral LR recession.
참고문헌 (21)
- Burian HM., "The surgical management of exodeviations", Am J Ophthalmol, 59, pp.603~620 (1965)
- Binion WW., "The surgical treatment of intermittent exotropia", Am J Ophthalmol, 61(5 Pt 1), pp.869~874 (1966)
- Deutsch JA., "Unilateral lateral rectus recession for the treatment of exotropia", Ann Ophthalmol, 24, pp.111~113 (1992)
- Nelson LB., "An alternative approach to the surgical management of exotropia-the unilateral lateral rectus recession", J Pediatr Ophthalmol Strabismus, 29, pp.357~360 (1992)
- Spierer A., "Unilateral and bilateral lateral rectus recession in exotropia", Ophthalmic Surg Lasers Imaging, 36, pp.114~117 (2005)
- Wang L., "Outcome study of unilateral lateral rectus recession for small to moderate angle intermittent exotropia in children", J Pediatr Ophthalmol Strabismus, 47, pp.242~247 (2010)
- Weakley DR Jr., "Unilateral lateral rectus recessions in exotropia", Ophthalmic Surg, 24, pp.458~460 (1993)
- Oh JY., "Survival analysis of 365 patients with exotropia after surgery", Eye(Lond), 20, pp.1268~1272 (2006)
- Maruo T., "Intermittent exotropia surgery in children : long term outcome regarding changes in binocular alignment. A study of 666 cases", Binocul Vis Strabismus Q, 16, pp.265~270 (2001)
- Moon KJ., "The long-term effect of unilateral lateral rectus muscle recession for moderate angle exotropia", J Korean Ophthalmol Soc, 39, pp.1885~1890 (1998)
- Kim JY., "The effect of unilateral lateral rectus recession in recurrent exotropia", J Korean Ophthalmol Soc, 36, pp.2261~2265 (1995)
- 이경숙, "Comparison of Outcomes of Unilateral Lateral Rectus Recession for Exotropia between First and Second Operations", Korean Journal of Ophthalmology, 25(5), pp.329~333 (2011), 대한안과학회
- Wright KW., "Practical aspects of the adjustable suture technique for strabismus surgery", Int Ophthalmol Clin, 29, pp.10~15 (1989)
- Kim HJ., "Long-term outcomes of unilateral lateral rectus recession versus recess-resect for intermittent exotropia of 20-25 prism diopters", BMC Ophthalmol, 14, pp.46~ (2014)
- Dadeya S., "Long-term results of unilateral lateral rectus recession in intermittent exotropia", J Pediatr Ophthalmol Strabismus, 40, pp.283~287 (2003)
- Ekdawi NS., "Postoperative outcomes in children with intermittent exotropia from a population-based cohort", J AAPOS, 13, pp.4~7 (2009)
- Feretis D., "Excessive single lateral rectus muscle recession in the treatment of intermittent exotropia", J Pediatr Ophthalmol Strabismus, 27, pp.315~316 (1990)
- Sohn JH., "Management for reoperation in recurrent exotropia", J Korean Ophthalmol Soc, 35, pp.580~584 (1994)
- 김원제, "외직근후전 및 내직근절제술 후 재발한 간헐외사시의 재수술 후 경과", 대한안과학회지, 50(9), pp.1386~1391 (2009), 대한안과학회
- Lee SY., "The effect of unilateral lateral rectus muscle recession over 11mm in the treatment of intermittent exotropia of 15-20PD", J Korean Ophthalmol Soc, 40, pp.550~554 (1999)
- Olitsky SE., "Unilateral rectus resection in the treatment of undercorrected or recurrent strabismus", J Pediatr Ophthalmol Strabismus, 38, pp.349~353 (2001)