부분조절내사시 수술 후 원시안경 교정의 변화
Changes in Hypermetropic Spectacle Correction after Surgery in Partially Accommodative Esotropia
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
목적: 부분조절내사시 환자에서 내사시 수술 후 정위를 유지하기 위해 필요한 원시안경 도수 변화 양상을 알아보고, 수술 후 원시안경을 벗을 수 있는 환자의 특징을 알아보고자 하였다. 대상과 방법: 부분조절내사시에 대해 전통적 방법에 준한 내사시 교정 수술을 받은 104명 중 수술 후 2년 이상 경과 관찰이 가능했던64명을 선정하였다. 수술 후 원시안경을 벗은 28명을 안경중단군, 원시안경이 계속 필요한 36명을 안경유지군으로 분류해 초진 시와수술 시 나이, 수술 전 전체 내사시각과 원시 교정 후 잔여 내사시각, 수술 후 1일째 사시각, 원시안경 도수 감량 시기, 관찰 기간을비교하였으며, 안경중단군에서 안경을 벗은 시점을 조사하였다. 결과: 안경중단군과 안경유지군의 초진 시와 수술 시 나이, 수술 후 1일째 사시각과 관찰 기간은 통계학적 차이가 없었다. 안경교정전 전체 내사시각은 안경중단군에서 통계적으로 유의하게 작았으나(37.4PD:46.7PD, p＜0.05), 안경 교정 후 잔여 내사시각은 두 군간 차이 없었다. 안경중단군의 초진 시 평균 안경도수는 3.0D로 안경유지군의 4.7D보다 유의하게 작았으나(p＜0.05), 수술 후 원시안경 감량 시기는 두 군 간 유의한 차이 없었다(18.8개월:27.5개월, p=0.14). 결론: 부분조절내사시 수술 후 원시안경을 중단한 환자군이 원시안경이 계속 필요했던 환자군에 비해 수술 전 평균 안경도수가 낮고,원시안경 교정 전 전체 내사시각 크기가 작았다. 따라서, 부분조절내사시 환자에서 수술 후 안경 중단 여부를 예측하는 데 도움이될 것으로 생각한다.
Abstract
Purpose: To investigate the characteristics of successfully weaning patients off of glasses and the change in hypermetropicspectacle correction required for maintaining orthotropia using an analysis of surgery results of patients with partially accommodativeesotropia. Methods: We reviewed the medical records of 104 patients who underwent standard surgery for correcting partially accommodativeesotropia. In total, 64 patients who had follow-up periods of at least 2 years were included. The patients were dividedinto 2 groups: 28 patients who were asked to discontinue their hyperopic glasses (glasses-discontinued group) and 36 patientswho still needed hyperopic glasses (glasses-maintained group). We investigated the age at first visit and at surgery, total angleof deviation and residual angle of deviation with correction before surgery, weaning time of hyperopic glasses, follow-up period,and the time at which the hyperopic glasses were discontinued in the glasses-discontinued group. Results: There were no statistically significant differences in the age at first visit and at surgery as well as the duration of postoperativefollow-up between both groups. The total esodeviated angle without hyperopic correction of the glasses-discontinuedgroup was significantly lower than that of glasses-maintained group (37.4PD:46.7PD, p < 0.05); there were no significant differencesin the remaining esotropic angle after hyperopic correction. The average hyperopic degree in the glasses-discontinuedgroup was significantly lower than that in the glasses-maintained group (+3.0D:+4.7D, p < 0.05), there were no significant differencesin the weaning time of hyperopic glasses between both groups. Conclusions: The esodeviated angle without hyperopic correction was smaller and hyperopic degree was lower in theglasses-discontinued group than in the glasses-maintained group after surgery for partially accommodative esotropia. Therefore, it might be helpful to predict the postoperative possibility to discontinue glasses in the patients with partially accommodativeesotropia.
참고문헌 (24)
- Mohney BG, "The longterm follow-up of accommodative esotropia in a population-based cohort of children", Ophthalmology, 118, pp.581~585 (2011)
- Rustein RP, "Clinical course of accommodative esotropia", Optom Vis Sci, 75, pp.97~102 (1998)
- Ludwig IH, "Long-term study of accommodative esotropia", J AAPOS, 9, pp.522~526 (2005)
- Berk AT, "Treatment outcomes in refractive accommodative esotropia", J AAPOS, 8, pp.384~388 (2004)
- Swan KC, "Accommodative esotropia long range follow-up", Ophthalmology, 90, pp.1141~1145 (1983)
- 서소연, "현성굴절검사로 추적관찰한 조절내사시에서의 안경중단 예측인자", 대한안과학회지, 52(2), pp.227~232 (2011), 대한안과학회
- Kim EJ, "Clinical assessment of partially accommodative esotropia", J Korean Ophthalmol Soc, 34, pp.447~451 (1993)
- 최안호, "부분조절내사시의 증량수술 후 장기 관찰 결과", 대한안과학회지, 44(8), pp.16~1838 (2003), 대한안과학회
- 양훈, "굴절조절내사시와 부분조절내사시의 임상 양상", 대한안과학회지, 45(4), pp.15~15 (2004), 대한안과학회
- 최병룡, "부분조절내사시 환자의 술 후 장기추적결과", 대한안과학회지, 45(11), pp.13~13 (2004), 대한안과학회
- 최덕규, "굴절조절내사시의 임상양상에 대한 10년간의 경과 관찰", 대한안과학회지, 52(11), pp.1331~1336 (2011), 대한안과학회
- Black BC, "The influence of refractive error management on the natural history and treatment outcome of accommodative esotropia", Trans Am Ophthalmol Soc, 104, pp.303~321 (2006)
- Wright KW, "Augmented surgery for esotropia associated with high hypermetropia", J Pediatr Ophthalmol Strabismus, 30, pp.167~170 (1993)
- Kim JC, "The clinical effect of augmented surgery for partially accommodative esotropia", J Korean Ophthalmol Soc, 36, pp.505~509 (1995)
- Kim YK, "Augmented surgery for partially accommodative esotropia", J Korean Ophthalmol Soc, 41, pp.2401~2407 (2000)
- Bietti GB, "Problems related to surgical overcorrection in strabismus surgery", J Pediatr Ophthalmol Strabismus, 2, pp.11~14 (1965)
- Dunnington JH, "Factors influencing the postoperative results in concomitant convergent strabismus", AMA Arch Ophthalmol, 44, pp.813~822 (1950)
- Lee JR, "The factors affecting consecutive exotropia with angle of 20 prism diopters or more following surgery for esotropia", J Korean Ophthalmol Soc, 36, pp.1778~1783 (1995)
- 이정호, "속발외사시의 임상양상과 수술예후", 대한안과학회지, 44(8), pp.17~1845 (2003), 대한안과학회
- 서정훈, "비조절내사시와 부분조절내사시의 수술 결과 비교", 대한안과학회지, 51(9), pp.1258~1263 (2010), 대한안과학회
- Banks MS, "Infant refraction and accommodation", Int Ophthalmol Clin, 20, pp.205~232 (1980)
- Lambert SR, "Accommodative esotropia", Ophthalmology Clinics of North America, 14, pp.425~432 (2001)
- Raab EL, "Hypermetropia in accommodative esodeviation", J Pediatr Ophthalmol Strabismus, 21, pp.64~68 (1984)
- Repka MX, "Changes in the refractive error of 94 spectacle-treated patients with acquired accommodative esotropia", Binoc Vis, 4, pp.15~21 (1989)