간헐외사시 술 후 초기 억제 및 입체시의 회복과 수술결과의 상관성
Relationship between Early Postoperative Stereoacuity and Surgical Outcome in Intermittent Exotropia
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목적: 간헐외사시 수술 후 억제 및 입체시의 회복과 수술 결과의 상관관계에 대하여 알아보고자 하였다. 대상과 방법: 간헐외사시 환자 중 단안 외직근 후전술 혹은 양안 외직근 후전술을 시행 받은 환자 중 3년 이상 경과관찰이 가능했던 74명을 대상으로 의무 기록을 후향적으로 분석하였다. 수술 후 Vectogram 억제 검사와 티트무스 검사를 시행하였으며 교대프리즘가림법으로 사시각을 측정하였다. 수술 후 사시각에 따라 수술 성공군, 재발군으로 나누어 두 군의 입체시를 비교하였다. 결과: 수술 후 1개월째 벡토그램 검사를 시행 후 비억제군과 억제군(단안 또는 교대)으로 나누었을 시에 술 후 1개월째 원거리 억제가 회복된 경우가 성공군에서는 55명(85.9%) 재발군에서는 5명(50.0%)이었으며 원거리 억제 회복이 수술 결과에 유의한 상관관계가 있었다(p=0.017). 또한 수술 후 1개월째 티트무스 검사를 시행하여 60초보다 좋은 입체시를 보인 정상 입체시를 보인 경우는 성공군에서는 49명(76.6%), 재발군에서는 4명(40.0%)이었으며 수술 후 근거리 입체시 회복도 수술 결과에 유의한 상관관계를 보였다(p=0.026). 결론: 원거리 억제 여부와 근거리 입체시가 간헐외사시 환자에서 수술 후 추적관찰 시 수술 성공을 예측할 수 있는 지표로 유용하게 사용할 수 있을 것이라 생각된다.
Abstract
Purpose: To identify the correlation between early postoperative stereoacuity and surgical outcome in intermittent exotropia. Methods: The medical records of 74 patients who underwent unilateral lateral rectus recession or bilateral lateral rectus recession for intermittent exotropia with a minimum postoperative follow-up of 3 years were retrospectively reviewed. Postoperative stereoacuity was measured using the vectogram test and Titmus test at 1 month post-operative. The deviation angle was measured at near and at distance using a prism cover test. Patients were divided into two groups according to post-operative angle deviation, and stereoacuity was analyzed in both groups. Results: Sixty patients showed no suppression at distance at 1 month post-operative follow-up. Of these, 55 patients (85.9%) belonged to the success group and 5 patients (50.0%) belonged to the recurrence group. The post-operative suppression test and the surgical outcome exhibited a significant association (p = 0.017). 53 patients showed normal stereoacuity 1 month after surgery. Of these, 49 patients (76.6%) belonged to the success group and 4 patients (40.0%) belonged to the recurrence group (p = 0.017). Post-operative stereoacuity and surgical outcome exhibited a significant association (p = 0.026). Conclusions: Post-operative suppression test results at distance and stereoacuity at near may be helpful in predicting surgical outcomes of patients with intermittent exotropia.
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