사시수술과 관련 없는 복시에 대한 프리즘안경의 치료 결과
Therapeutic Outcomes of Prism Glasses for Diplopia Unrelated to Strabismus Surgery
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목적: 사시수술과 관련 없이 복시를 동반한 사시가 지속되어 프리즘안경을 착용한 환자들의 치료 결과에 대하여 알아보고자 하였다. 대상과 방법: 2002년 5월부터 2016년 10월 사이에 사시수술과 관련 없이 복시를 동반한 사시로 프리즘 안경을 착용한 환자 23명의 의무기록을 후향적으로 조사하였다. 3개월 이내에 프리즘안경을 포기한 경우를 프리즘안경 적응 실패군, 3개월 이상 프리즘안경을 착용한 경우를 프리즘안경 적응 성공군으로 정의하였고, 적응 성공군에서 경과관찰 중 추가적인 사시수술이 필요하지 않았던 경우를치료 성공, 사시수술을 시행한 경우를 치료 실패로 정의하였다. 사시의 종류와 원인, 프리즘안경 착용 시작과 마지막 내원 시의 편위각, 프리즘안경 도수, 최대교정시력, 티트무스검사, 워트4등검사를 분석하였다. 결과: 전체 23명 중 수평사시가 18명, 수직사시가 4명, 혼합사시가 1명이었다. 사시 원인은 급성후천일치내사시 12명, 마비사시 9명, 갑상샘눈병증 2명이었다. 프리즘안경 착용 시작과 평균 23개월 이후의 마지막 내원 시의 편위각과 프리즘안경 도수는 통계적으로 유의한 차이가 없었다. 23명 중 16명(70%)에서 프리즘안경 적응 성공군에 해당하였으며, 이 중 5명(31%)에서만 사시수술을 시행하였다. 모든 환자에서 시력이 저하된 경우는 없었으며, 프리즘안경 적응 성공군 중 양안시가 불량한 경우는 33%였다. 결론: 사시수술과 관련 없이 복시를 동반하는 사시의 70%에서 3개월 이상 프리즘안경 치료에 적응하였고, 이 중 31%에서만 사시수술이 필요하였다. 따라서 사시수술과 관련 없이 복시를 동반하는 사시에서 비수술적 치료의 한 방법으로 프리즘안경 치료를 고려할수 있다.
Abstract
Purpose: To evaluate the therapeutic results of the patients wearing the prism glasses due to strabismus with diplopia unrelated to strabismus surgery. Methods: Between May 2002 and October 2016, this retrospective study evaluated medical records of 23 patients who were wearing prism glasses due to strabismus with diplopia unrelated to strabismus surgery. The patients failed to adjust to the prism glasses and stopped within 3 months were defined as the adaptation failure group. The patients wearing prism glasses for 3 months or more was defined as adaptation success group. In the prism adaptation success group, he patients who underwent strabismus surgery during follow up were defined as treatment failure. Data were collected the types and causes of strabismus, the deviation angle at starting treatment of prism glasses and last visits, best corrected visual acuity, Titmus stereo test and Worth 4 dot test. Results: Of the total 23 patients, 18 patients had horizontal strabismus, four patients had vertical strabismus and one had horizontal and vertical strabismus. The causes of strabismus were acute acquired comitant esotropia (12 patients), paralytic strabismus (9 patients), and thyroid associated ophthalmopathy (two patients). There was no significant changes in deviation angle as well as the prism diopter of prism glasses after prism glasses treatmet. The prism glasses-adaptation group was 70%, and 31% of them were performed strabismus surgery. There was no reduction in visual acuity in all patients. Among the prism glasses adaptation group, 33% of the prism glasses-adaptation group had poor binocular function. Conclusions: In the strabismus patients with diplopia unrelated to strabismus surgery 70% of the patients adapted prism glasses more than 3 months and 31% of them required strabismus surgery. Therefore, prism glasses treatment may be one of the non-surgical approaches in the strabismus patients with diplopia unrelated to strabismus surgery.
참고문헌 (20)
- Jang JH, "Factors predisposing to consecutive esotropia after surgery to correct intermittent exotropia", Graefes Arch Clin Exp Ophthalmol, 250, pp.1485~1490 (2012)[DOI]
- Rucker JC, "Binocular diplopia. A practical approach", Neurologist, 11, pp.98~110 (2005)[DOI]
- Biglan AW, "Management of strabismus with botulinum A toxin", Ophthalmology, 96, pp.935~943 (1989)[DOI]
- Veronneau-Troutman S, "Fresnel prism membrane in the treatment of strabismus", Can J Ophthalmol, 6, pp.249~257 (1971)
- Pigassou R, "The functional treatment of strabismus", Can J Ophthalmol, 7, pp.331~335 (1972)
- Knapp P, "Recent advances in strabismus management. Use of membrane prisms", Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol, 79, pp.718~721 (1975)
- Moore S, "An evaluation of the use of Fresnel press-on prisms in childhood strabismus", Am Orthopt J, 25, pp.62~66 (1975)[DOI]
- Lee EK, "Prismatic correction of consecutive esotropia in children after a unilateral recession and resection procedure", Ophthalmology, 120, pp.504~511 (2013)[DOI]
- Lee EK, "Long-term outcome of prismatic correction in children with consecutive esotropia after bilateral lateral rectus recession", Br J Ophthalmol, 99, pp.342~345 (2015)[DOI]
- Apers RC, "The use of prisms in paralytic squint", Am Orthopt J, 27, pp.53~60 (1977)[DOI]
- Tamhankar MA, "Success of prisms in the management of diplopia due to fourth nerve palsy", J Neuroophthalmol, 31, pp.206~209 (2011)[DOI]
- Gunton KB, "Prism use in adult diplopia", Curr Opin Ophthalmol, 23, pp.400~404 (2012)[DOI]
- Lee HS, "Acute acquired comitant esotropia related to excessive smartphone use", BMC Ophthalmol, 16, pp.37~ (2016)[DOI]
- 김연희, "속발내사시에서 프레넬프리즘의 치료 효과", 대한안과학회지, 47(10), pp.1623~1629 (2006), 대한안과학회
- Flanders M, "Fresnel membrane prisms: clinical experience", Can J Ophthalmol, 34, pp.335~340 (1999)
- Lee HH, "Prismatic effect and visual acuity degradation", J Korean Ophthalmol Soc, 36, pp.909~914 (1995)
- Kim SJ, "Fresnel prism in paralytic strabismus", J Korean Ophthalmol Soc, 38, pp.129~134 (1997)
- Wright D, "Comparison of the visual effects of Fresnel prisms in normal and amblyopic eyes", J AAPOS, 12, pp.482~486 (2008)[DOI]
- Brown SM, "Fresnel prism treatment of sensory exotropia with restoration of sensory and motor fusion", J Cataract Refract Surg, 25, pp.441~443 (1999)[DOI]
- 최경섭, "The Prismatic Effect on Stereoacuity in Intermittent Exotropia", Yonsei Medical Journal, 51(1), pp.117~120 (2010), 연세대학교의과대학