외사시 수술 3년 후 결과 분석
Three-Year Surgical Outcome of Exotropia
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목적: 외사시 수술 후 3년 이상 관찰한 결과를 분석하고, 수술 결과에 영향을 미치는 요인에 대하여 알아보고자 하였다. 대상과 방법: 외사시로 수술 받고 3년 이상 경과 관찰한 259명의 의무기록을 후향적으로 분석하였다. 수술 3년 후 일차 안위에서 5프리즘디옵터(Δ) 이내의 내편위, 정위 혹은 10Δ 이내 외편위인 경우를 성공군, 5Δ를 초과하는 내편위를 과교정군, 10Δ를 초과하는 외편위를 재발군으로 정의하였다. 과교정군과 재발군을 묶어 실패군으로 정의하였다. 수술시 연령, 성별, 술전 굴절이상, 술전 입체 시,술전 최대사시각, 수술 방법, 수술 1주 후 사시각 등 여러 요인을 분석하였다. 결과: 259명의 환자 중 수술 3년 후 성공군이 155명(59.8%), 과교정군 19명(7.3%), 재발군 85명(32.8%)이었다. 전체 환자 중 44명(17.0%)이 재수술을 받았으며, 이 중 과교정군 2명, 재발군이 42명이었다. 수술 1주 후 사시각만이 수술 결과와 유의한 상관관계를보였다. 수술 방법만이 재수술여부와 유의한 상관관계를 보였다. 결론: 수술 1주 후 사시각만이 수술 결과와 유의한 상관관계를 보였으며, 수술 방법만이 재수술 여부와 유의한 상관관계를 보였다.
Abstract
Purpose: To investigate surgical results (≥3 years) for exotropia and factors associated with the outcome. Methods: Clinical records of 259 patients who underwent surgery for exotropia and had 3 or more years of follow-up were retrospectively reviewed. Surgical success was defined as esodeviation less than 5 prism diopters (Δ), orthophoria, or exodeviation less than 10Δ on the third year after operation. Overcorrection was defined as esodeviation greater than 5Δ and recurrence as exodeviation greater than 10Δ. Both overcorrection and recurrence were considered as surgical failure. Factors including age at surgery, gender, preoperative refractive errors, preoperative stereopsis, preoperative maximum deviation, type of surgery, and alignment at postoperative week 1 were investigated. Results: Out of 259 patients, 155 patients (59.8%) achieved surgical success, 19 patients (7.3%) showed overcorrection and 85 patients (32.8%) had recurrence. Out of 44 patients (17.0%) who underwent reoperation, 2 patients showed overcorrection and 42 patients had recurrence. Alignment at postoperative week 1 was the only significant factor affecting the surgical results. The type of surgery was the only significant factor associated with reoperation after failure of the initial surgery. Conclusions: Alignment at postoperative week 1 was the only significant factor affecting surgical results. The type of surgery was the only significant factor associated with reoperation.
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