비조절내사시와 부분조절내사시의 수술 결과 비교
The Comparison of Surgical Results Between Non-accommodative and Partially Accommodative Esotropia
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목적: 비조절내사시와 부분조절내사시에서 수술 후 장기적 결과에 차이가 있는지를 알아보고자 하였다. 대상과 방법: 내사시 수술 후 2년 이상 관찰된 소아 47명을 대상으로 하였다. 원시안경을 착용한 후의 내사시각이 안경을 착용하지않은 상태의 내사시각보다 10프리즘디옵터(PD) 이상 작은 경우를 부분조절내사시군으로, 이외의 경우를 비조절내사시군으로 정하였다. 두 군 사이에 수술 시 나이, 사시각, 약시의 유무, 수술 후 시간 경과에 따른 사시각 변화를 비교하였다. 최대 안경 교정 후의 사시각이 10PD 이내인 경우를 수술에 성공한 것으로 정하였다. 결과: 부분조절내사시군 29명, 비조절내사시군 18명이었고, 수술 시 나이는 부분조절내사시군에서 비조절내사시군보다 많았다(5.5:1.7세). 수술 전 사시각은 부분조절내사시군에서 비조절내사시군보다 작았으며(24.2:51.7PD), 약시 빈도의 차이는 없었다(72.4:61.1%). 술 후2년째와 최종 성공률 모두 부분조절내사시군에서 더 높았다(93.1:64.7%, 82.8:50.0%). 결론: 내사시로 수술한 소아에서 원시 안경으로 내사시각이 감소한 경우의 장기적 수술 결과가 내사시각이 차이가 없었던 경우에 비하여 더 양호하였다.
Abstract
Purpose: To examine the differences in surgical results between non-accommodative esotropia (NAE) and partially accommodative esotropia (PAE). Methods: This retrospective study included 47 patients undergoing surgery for pediatric esotropia, defined as esotropia with a decrease in the deviated angle of greater than ten prism diopters (PD) upon administration of hyperopic spectacles. On the other hand, NAE was defined as esotropia with a decrease in the deviated angle of less than 10PD. We compared age at surgery, deviated angle at surgery, frequency of amblyopia, and deviated angle at each postoperative period in two groups. Results: Twenty-nine patients belonged to the PAE group, and 18 patients belonged to the NAE group. The age at surgery in the PAE group was higher than that of the NAE group, and the deviated angle for surgical correction was smaller in the PAE group than in the NAE group. No statistically significant difference in the frequency of amblyopia presentation was found between the two groups. The surgical success rates were much higher in the PAE group at postoperative two years and at the final visit compared to those of the NAE group. Conclusions: In esotropic children who underwent surgery, the long-term surgical success rate was highest in the cases in which the esotropic angle was decreased by hyperopic correction.
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