외사시 환자에서 사시각에 따른 단안 혹은 양안 외직근 후전술 후 사시각 변화와 편차의 비교
Change of Strabismus Angle and Deviation After Unilateral or Bilateral Lateral Rectus Recession in Exotropia
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목적: 외사시 환자에서 양안 외직근 후전(1군)과 단안 외직근 후전(2군) 후 사시각 변화와 그 편차를 비교하고자 하였다. 대상과 방법: 외사시 수술 환자 198명의 사시각 변화와 그 편차를 후향적으로 조사하였다. 1군은 116명, 2군은 82명이었고 25PD 이상은 1군, 25PD 미만은 2군에 속하였다. 4PD 이하의 내편위, 10PD 이하의 외편위를 보이는 군을 수술의 성공군으로, 나머지를 실패군으로 하였다. 결과: 술 후 1주와 1년의 평균 사시각은 1군에서 -1.96D ± 4.75, 2.5D ± 7.82, 2군에서 0.77D ± 2.87, 5.94D ± 3.38이었다. 실패군은 1군이 30명, 1년 후 평균 사시각 5.42D ± 13.97, 2군이 24명, 1년 후 평균 사시각 13.79 ± 3.04으로 통계학적으로 유의한 차이가 있었 다. 실패군에서 1군이 2군에 비해 평균 사시각은 작으나 편차가 크게 나타났으며 1군 실패군 30명 중 과교정된 경우는 9명, 부족 교정 된 경우는 21명이고 2군에서는 24명 전례에서 부족 교정되었다. 결론: 외직근 후전술 후 사시각 변화와 편차는 양안 외직근 후전술을 시행한 경우에 단안을 시행한 경우보다 더 크게 나타났다.
Abstract
Purpose: To compare the changes in strabismus angle and deviation between two groups: a bilateral lateral rectus recession (Group 1) and a unilateral lateral rectus recession in exotropia (Group 2). Methods: A retrospective survey was conducted on 198 patients who had received exotropia surgery in our ophthalmology clinic from September 2003 to April 2007. A total of 116 patients were in Group 1, and 82 patients were in Group 2. Unilateral lateral rectus recession was performed on patients under 25 PD, and bilateral lateral rectus recession was performed on patients above 25 PD. A case of less than 4 PD esodeviation and less than 10 PD exodeviaton was defined as a success and any other case as a failure at the 1-year follow-up visit. Results: The average deviations of the first postoperative month and the first postoperative year were -1.96 D ± 4.75, 2.5 D ± 7.82 for Group 1 and 0.77 D ± 2.87, 5.94 D ± 3.38 for Group 2. Revealing statistical significance between the 2 Groups: Group 1 had 30 failure cases (25.9%) and their 1 postoperative year average deviation was 5.42 D ± 13.97, while Group 2 showed 24 failure cases (29.3%) and their 1-postoperative-year average deviation was 13.0-79 ± 3.04. Group 1 had less strabismus angle and a greater standard deviation than Group 2, as Group 1 had more overcorrection. Among the 30 failure cases of Group 1, 9 were overcorrected and 21 were undercorrected, but all 24 failure cases in Group 2 were undercorrected. Conclusions: The strabismus angle after lateral rectus recession showed a wider variation and a larger difference in bilateral lateral rectus recession than in the unilateral lateral rectus recession.
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