주시안을 가진 간헐외사시의 편위안 증량 비대칭 외직근후전술
Augmented Asymmetric Lateral Rectus Recession in Intermittent Exotropia With Fixing Eye
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목적: 주시안을 가진 간헐외사시의 일차 수술로 편위안 증량 비대칭 외직근후전술의 결과를 양안 대칭 외직근후전술과 비교하고자하였다. 대상과 방법: 주시안을 가진 간헐외사시 진단하에 양안 외직근후전술을 시행받고 술 후 6개월 이상 추적관찰이 가능했던 환자 중,양안 대칭 외직근후전술 27명과 편위안 증량 비대칭 외직근후전술 24명의 의무기록을 후향적으로 분석하였다. 교대 간헐외사시인 경우와 편위안의 시력이 0.3 이하인 경우를 제외하였고, 편위안 증량 외직근후전술은 편위안에 주시안보다 2.0 mm 이상 더 많은 양을후전하였다. 결과: 술 후 5PD 이내의 내사위와 10PD 이내의 외사위를 수술 성공으로 정의하였을 때, 최종 내원 시 양안 대칭 외직근후전술군은75.0%, 편위안 증량 비대칭 외직근후전술군은 81.2%의 성공률을 보여 편위안 증량 수술군에서 다소 높았으나 통계적으로 유의하지는않았다(P=0.261). 결론: 주시안을 가진 간헐외사시 환자의 편위안에 비편위안보다 2.0 mm 더 많은 후전을 시행한 편위안 증량 외직근후전술군은 양안에동일한 양을 후전한 대칭 외직근후전술군에 비해 술 후 24개월까지 유의한 차이가 없었다.
Abstract
Purpose: To document and compare the clinical results of symmetrical rectus muscle recession and asymmetrical rectus muscle recession in intermittent exotropia. Methods: The medical records of 27 patients who had symmetric bilateral rectus recession and 24 patients who had asymmetric bilateral rectus recession for intermittent exotropia with at least six months of postoperative follow-up from March 2004 to March 2007 were reviewed retrospectively. The authors performed a recession of 2 mm or greater in the deviating eye than in the fixing eye. Results: The mean age was 7.14±4.23 (range 3 to 15) years for symmetric bilateral rectus recession and 7.33±4.01 (range 3to 14) years for asymmetric bilateral rectus recession. The mean follow-up was 11.83±5.74 (range 6 to 26) months in the symmetric bilateral rectus recession group and 11.14±5.05 (range 6 to 30) months in the asymmetric bilateral rectus recession group. The mean preoperative angle deviations were 27.5±4.8 prism diopter (PD) (range 30 to 40PD) and 27.3±4.6PD (range 20 to 40PD) in each group. The outcome of final follow-up (postoperative 24 months) was favorable in both groups, and slightly more successful in the asymmetric bilateral recession group but not a statistically significant amount (75.5% in the symmetric bilateral recession group and 81.2% in the asymmetric bilateral recession group). Conclusions: The present study suggests that there are no significant differences at postoperative 24 months between symmetric bilateral recession and asymmetric bilateral recession in intermittent exotropia having a fixing and a deviating eye.
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