상사근기능항진에서 상사근힘줄절제술 및 상사근뒤쪽힘줄절제술의 교정 효과
Tenectomy and Posterior Tenectomy of the Superior Oblique for Superior Oblique Overaction
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목적: 상사근힘줄절제술과 뒤쪽힘줄절제술의 상사근기능항진의 교정 효과를 비교하였다. 대상과 방법: 2005년 4월부터 2010년 11월까지 상사근힘줄절제술 및 뒤쪽힘줄절제술을 받고 수평직근 수술을 병행한 19명 30안을 대상으로 하였다. 단안 상사근힘줄절제술 3명, 단안 상사근뒤쪽힘줄절제술 5명, 양안 상사근힘줄절제술 3명, 양안 상사근뒤쪽힘줄절제술6명, 상사근힘줄절제술과 뒤쪽힘줄절제술을 양안에 각각 시행한 2명의 기록을 후향적으로 분석하였다. 결과: 평균연령은 14.2세이고 술 후 관찰 기간은 평균 20개월이었다. 상사근힘줄절제술(11안)과 상사근뒤쪽힘줄절제술(19안)을 통해상사근기능항진이 +2.27, +1.84에서 +0.09, +0.39로 호전되었다. 힘줄절제술을 시행한 11안 중 1안을 제외하고 상사근기능항진이 관해되었으나, 뒤쪽힘줄절제술 후 6안에서 기능항진이 남아 교정 효과의 차이가 있었다. 두 방법 모두 수직사시의 교정 효과는 미미하였다. 결론: 상사근기능항진의 장기적인 교정 효과는 상사근힘줄절제술에서 더 우수하였으나 중등도 이상의 기능항진에서 뒤쪽힘줄절제술도 유사한 교정 효과를 보였다. 두 방법 모두 합병증이 적고 효과적인 상사근약화술로 생각한다.
Abstract
Purpose: The authors of the present study compared the effects of tenectomy and posterior tenectomy of the superior oblique for treating superior oblique overaction (SOOA). Methods: The records of 30 eyes of 19 patients who underwent tenectomy or posterior tenectomy of the superior oblique alone or in combination with surgery on other horizontal rectus muscles from April 2005 through November 2010 were reviewed. The review was performed in 3 patients who underwent unilateral superior oblique tenectomy, 5 patients who underwent unilateral superior oblique posterior tenectomy, 3 patients who underwent bilateral superior oblique tenectomy,6 patients who underwent bilateral superior oblique posterior tenectomy, and 2 patients who underwent superior oblique posterior tenectomy and tenectomy. Results: The mean age of the patients was 14.2 years, and the mean follow-up period was 20 months. Through superior oblique tenectomy (11 eyes) and superior oblique posterior tenectomy (19 eyes), the amount of SOOA decreased from +2.27 to +0.09 and from +1.84 to +0.93, respectively. Except for 1 out of 11 eyes with superior oblique tenectomy, SOOA was completely corrected, although SOOA remained in 6 eyes after posterior tenectomy. Therefore, the correctional effects of the 2 methods differed; both procedures showed insignificant correctional effects on vertical strabismus. Conclusions: Superior oblique tenectomy has a superior long-term weakening effect; however, posterior tenectomy showed a comparable effect in the patient with moderate to severe SOOA. Both of these methods had few complications and are considered to be effective superior oblique weakening procedures.
참고문헌 (20)
- Harcourt B, "Superior oblique muscle surgery", Aust J Ophthalmol, 12, pp.167~169 (1984)
- Sharma P, "Thanikachalam. Evaluation of superior oblique weakening procedures", J Pediatr Ophthalmol Strabismus, 36, pp.189~195 (1999)
- Roizen A, "Superior oblique anterior tenectomy", J AAPOS, 12, pp.54~57 (2008)
- Vempali VM, "Results of superior oblique posterior tenotomy", J AAPOS, 2, pp.147~150 (1998)
- Heo H, "Effect of 10-mm superior oblique posterior tenectomy combined with frenulum dissection in A-pattern with superior oblique overaction", Am J Ophthalmol, 148, pp.794~799 (2009)
- Sharma P, "Effect of posterior tenectomy of the superior oblique on objective and subjective torsion in cases of superior oblique overaction", J Pediatr Ophthalmol Strabismus, 42, pp.284~289 (2005)
- Shin GS, "Posterior superior oblique tenectomy at the scleral insertion for collapse of A-pattern strabismus", J Pediatr Ophthalmol Strabismus, 33, pp.211~218 (1996)
- Yagasaki T, "Posterior tenotomy of the superior oblique at the scleral insertion for A-pattern deviations", Jpn J Ophthalmol, 39, pp.83~88 (1995)
- Prieto-Diaz J., "Management of superior oblique overaction in A-pattern deviations", Graefes Arch Clin Exp Ophthalmol, 226, pp.126~131 (1988)
- Prieto-Diaz J., "Posterior tenectomy of the superior oblique", J Pediatr Ophthalmol Strabismus, 16, pp.321~323 (1979)
- Souza-Dias C, "Efficacy of different techniques of superior oblique weakening in the correction of the "A" anisotropia", J Pediatr Ophthalmol Strabismus, 23, pp.82~86 (1986)
- Drummond GT, "Recession of the superior oblique tendon in A-pattern strabismus", Can J Ophthalmol, 25, pp.301~305 (1990)
- Wright KW., "Oblique overaction and A-pattern and V-patterns, In Pediatric Ophthalmology and Strabismus, 1st ed", pp.203~209 (1995), Mosby
- Del Monte MA, "Denervation and extirpation of the inferior oblique. An improved weakening procedure for marked overaction", Ophthalmology, 90, pp.1178~1185 (1983)
- Bedrossian EH, "Bilateral superior oblique tenectomy for the A-pattern in strabismus", Arch Ophthalmol, 78, pp.334~336 (1967)
- Urist MJ, "Complications following bilateral superior oblique weakening surgical procedures for A-pattern horizontal deviations", Am J Ophthalmol, 70, pp.583~587 (1970)
- McNeer KW, "Untoward effects of superior oblique tenotomy", Ann Ophthalmol, 4, pp.747~750 (1972)
- Ron Y, "Z-tenotomy of the superior oblique tendon and horizontal rectus muscle surgery for A-pattern horizontal strabismus", J AAPOS, 13, pp.27~30 (2009)
- Minguini N, "A study to determine: should conventional amounts of eye muscle surgery for horizontal binocular deviations be changed when oblique muscle weakening procedures are simultaneously performed?", Binocul Vis Strabismus Q, 20, pp.21~25 (2005)
- Jin YH, "The effect of bilateral superior oblique tenotomy on primary position horizontal alignment", J Korean Ophthalmol Soc, 40, pp.573~578 (1999)