속발내사시 수술 전후 임상경과

• Published in: Daihan angwa haghoi jabji Vol. 53; no. 3; pp. 446 - 451
• Main Authors: 최덕규, Duk Kyu Choi, 최미영, Mi Young Choi
• Format: Journal Article
• Language: Korean
• Published: 대한안과학회 15.03.2012
• Subjects: Binocularity; Consecutive esotropia; Exotropia; 안과학; Exotropia; Consecutive esotropia; Binocularity
• ISSN: 0378-6471; 2092-9374

목적: 속발내사시로 수술받은 환자의 수술 전후 임상양상을 분석하고, 수술 후 최종 결과를 알아보았다. 대상과 방법: 외사시 수술 후 발생한 속발내사시가 지속되어 수술받은 12명을 대상으로 하였다. 사시각, 속발내사시 지속 기간, 내사시수술 전 치료 방법, 수술 후 경과를 조사하였다. 외사시 수술 전, 속발내사시 지속 시, 속발내사시 수술 후 입체시와 융합력을 비교하였다. 결과: 12명의 외사시 수술 전 사시각은 27.5PD였고 3명에서 가쪽불일치가 있었다. 내사시가 지속되는 동안 우선 교대가림하였으며, 이 중 10명은 프레넬프리즘을 착용하였다. 속발내사시수술 전 내사시각은 24.3PD이었고, 수술 후 평균 30개월 관찰하였다. 9명은 정위 또는 8PD 이내의 내편위를 보였고, 2명은 15PD 내사시, 1명은 20PD 외사시를 보였다. 속발내사시가 있는 동안 입체시가 불량해졌던 3명과 융합력이 저하되었던 1명은 내사시수술 후 회복되었다. 전체 관찰 기간 중 시력이 저하된 경우는 없었다. 결론: 외사시 수술 후 발생한 속발내사시가 있는 동안 교대가림과 프리즘렌즈를 착용한 결과 양안시가 저하되는 빈도는 낮았으며, 내사시 수술 후 회복되었다. 속발내사시 수술 후 75%에서 정위를 유지하였다. Purpose: To report the clinical outcome of patients with consecutive esotropia (ET) in the pre- and post-operative periods and at the last postoperative visit. Methods: The present study included 12 patients who underwent surgery for the correction of consecutive ET. The angle of deviation, duration of consecutive ET, and surgical and non-surgical methods for correction of consecutive ET were investigated. The sensory status was evaluated before the surgery of exotropia (XT), during consecutive ET and after the surgery for consecutive ET. Results: The average angle of deviation before the surgery of XT was 27.5 PD and 3 patients had lateral incomittancy. Alternate occlusion treatment was performed in all patients, and 10 patients wore Fresnel prisms. The average angle of deviation of consecutive ET was 24.3 PD. After an average of 30 months postoperative consecutive ET, 9 patients were orthotropic or had deviation within 8 PD, 2 patients had 15 PD ET, and 1 patient had 20 PD XT. There were 3 patients whose stereopsis was aggravated and 1 patient had poorer fusion during consecutive ET, and recovered after the surgery for consecutive ET. No patients had a decrease in visual acuity. Conclusions: As a result of alternate occlusion and Fresnel prisms during consecutive ET after surgery of XT, the incidence of aggravation in binocularity was low, and the cases with aggravated binocularity were recovered after surgical correction of consecutive ET. The surgical success rate was 75% in consecutive ET.