하사근기능항진 환자에서 하사근절제술의 효과 분석
Analysis of Effect of Inferior Oblique Myectomy in Patients With Inferior Oblique Overaction
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목적: 하사근기능항진이 동반된 사시환자에서 하사근기능항진, 상사시, 외회선의 하사근절제술 전후의 상관관계를 분석하여 하사근절 제술의 교정효과를 알아보고자 한다. 대상과 방법: 하사근기능항진으로 하사근절제술을 단독 혹은 기타 사시교정수술과 함께 시행받은 환자 59명 86안에 대하여 하사근기능 항진, 상사시, 외회선의 수술 전후량 및 변화량 사이의 상관관계를 비교 분석하였다. 결과: 하사근기능항진은 술전 +2.5 ± 0.6, 술후 -0.01 ± 0.25 (p＜0.05), 상사시는 술전 5.7 ± 6.3PD (prism diopter), 술후 2.3 ± 5.2PD (p＜0.05), 외회선은 술전 15.3 ± 7.6°, 술후 6.6 ± 5.7°(p＜0.05)로 유의하게 감소하였다. 수술전 하사근기능항진량과 하사근기능항 진 교정량, 수술전 상사시 정도와 상사시 교정량은 유의한 양의 상관관계를 보였다(p＜0.05, p＜0.05). 술전 외회선 정도와 외회선 교정량도 양의 상관관계를 보이나 통계적으로 유의하지 않았다(p=0.05). 결론: 하사근절제술은 하사근기능항진 환자에서 하사근기능항진, 상사시, 외회선의 술전 정도에 따른 적절한 교정효과를 나타내었다.
Abstract
Purpose: To investigate the effect of inferior oblique (IO) myectomy by analyzing the correlation of the amount of inferior oblique overaction (IOOA), hypertropia and excyclotorsion before, between, and after IO myectomy in patients with various degrees of IOOA. Methods: A total of 86 eyes from 59 patients with IOOA who underwent IO myectomy were enrolled in the present study. The correlation analysis was performed for the amount of IOOA, hypertropia and excyclotorsion before and after surgery, according to the preoperative amount of IOOA, hypertropia, and excyclotorsion. Results: The IOOA decreased from +2.5 ± 0.6 before surgery to -0.01 ± 0.25 (p < 0.05) after surgery. The vertical deviation was 5.7 ± 6.3 prism diopter (PD) and 2.3 ± 5.2 PD (p < 0.05) postoperatively. The amount of cyclodeviation was 15.3 ± 7.6° before surgery and 6.6 ± 5.7° (p < 0.05) after surgery. The amount of surgical correction for IOOA and the hypertropia was significantly correlated with preoperative deviation (p < 0.05, p < 0.05). The amount of excyclotorsion before and after surgery was also positively correlated but was not statistically significant (p = 0.05). Conclusions: IO myectomy can correct any degree of IOOA, hypertropia, and related excyclotorsion.
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