한 눈 중등도 일차하사근기능항진 환자에서하사근후전술 후 발생한 반대편 눈의 하사근기능항진
Contralateral Inferior Oblique Overaction after Inferior Oblique Recession in Unilateral Moderate Primary Inferior Oblique Overaction
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목적: 한 눈 중등도(+2와 +3) 일차하사근기능항진 환자에서 하사근후전술 후 반대편 눈의 하사근기능항진의 발생률과 반대편 눈에시행한 하사근후전술의 효과를 알아보고자 하였다. 대상과 방법: 한 눈의 일차하사근기능항진으로 한 눈 하사근후전술을 시행받고 1년 이상의 경과관찰이 가능하였던 88명의 환자를 대상으로 의무기록을 후향적으로 조사하였다. 하사근기능항진의 정도에 따라 단계적 하사근후전술을 시행하였으며 수술 후 하사근기능항진이 +1 이하이면 성공으로 하였고 수술 후 반대편 눈에 하사근기능항진이 +2 이상이면 하사근기능항진이 발생하였다고 간주하였다. 결과: 수술 전 하사근기능항진이 +2인 경우에 98.2%, +3인 경우는 100%로, 전체적으로는 98.8%에서 성공을 보였고, 수술 후 반대편눈의 하사근기능항진의 발생은 수술 전 하사근기능항진이 +2인 경우에 24.1%, +3인 경우에는 16.6%로, 전체적으로 21.6%에서 반대편눈의 하사근기능항진이 발생하여 반대편 눈의 하사근후전술을 시행하였으며 모든 환자에서 성공을 보였다. 결론: 한 눈 중등도 일차하사근기능항진에서 한 눈 하사근후전술을 시행하였을 때 21.6%에서 반대편 눈의 하사근기능항진이 발생하였으나 그 눈에 시행한 하사근후전술로 좋은 결과를 얻을 수 있었다.
Abstract
Purpose: To investigate the incidence rate of inferior oblique muscle overaction (IOOA) in the contralateral eye and the effect of inferior oblique (IO) muscle recession of the contralateral eye in the patients who received IO muscle recession for unilateral moderate (+2 or +3) primary IOOA. Methods: Medical records of 88 patients with unilateral primary IOOA who underwent unilateral IO muscle recession were retrospectively reviewed and observed during a follow-up period of more than 1 year. Graded recession of the IO muscle was performed according to the degree of IOOA. If postoperative IOOA was below +1, the surgery was considered successful. If IOOA in the contralateral eye was more than +2 after surgery, the IOOA was considered to have occurred. Results: In cases where IOOA was +2 and +3 before the surgery, the success rate was 98.2% and 100%, respectively,showing an overall success rate of 98.8%. The incidence of contralateral IOOA after recession of the unilateral IO muscle was 24.1% in the +2 group and 16.6% in the +3 group with an overall incidence rate of 21.6% and when the IO muscle recession of the contralateral eye was performed, the success rate was 100%. Conclusions: The incidence of contralateral IOOA was 21.6% after the unilateral IO muscle recession in moderate unilateral primary IOOA. A satisfactory outcome was obtained through an additional IO muscle recession in the contralateral eye.
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