중등도 이하의 기본간헐외사시에서 사시각에 따른 수술 후 결과 및 입체시 비교

Abstract

Purpose: This study was conducted to compare the surgical outcomes and stereoacuities after medial rectus (MR) muscle and lateral rectus (LR) muscle recessions, as deviation angle in 20-30 PD basic intermittent exotropia. Methods: A total of 72 patients were classified into three groups, according to the deviation angle and measured stereoacuities. Twenty-five patients in Group 1, with a deviation angle of 20 prism diopter (PD), underwent MR resection of 4.0 mm and LR recession of 5.0 mm. Group 2, which consisted of 26 patients with 25 PD, underwent 5.0 mm and 6.0 mm. And 21 patients in Group 3 with 30 PD underwent 5.5 mm and 7.0 mm. The success of surgery was determined by the range of a deviation angle within ±8 PD for both near and distance. Results: The average age was 7.8 years, 7.2 years, and 8.6 years in Group 1, Group 2, and Group 3, respectively. On the final observation, the success rate of the surgery was 84%, 88%, and 90.4% in Group 1, Group 2, and Group 3, respectively. There was no case of overcorrection. Near stereoacuities was found without significant difference at preoperative with postoperative in Group 1, Group 2, and Group 3, respectively (p = 0.26). Postoperative distance stereoacuities showed significant improvements in Group 1, Group 2, and Group 3 (p = 0.04). Conclusions: Basic intermittent exotropia, which has deviation angle of 20, 25, 30 PD showed no difference in surgical outcomes, according to the deviation angle. There were improvements in the distance stereoacuities after MR resection and LR recession procedure.

목적: 20-30 Prism diopters (PD) 사이의 기본간헐외사시에서 사시각 크기에 따라 내직근절제와 외직근후전 후 입체시와 수술결과를 비교하고자 하였다. 대상과 방법: 72명을 대상으로 사시각에 따라 3군으로 분류하여 입체시를 측정하였고, 사시각이 20PD인 25명(1군)은 내직근절제술 4.0mm, 외직근후전술 5.0 mm, 25PD인 26명(2군)은 5.0 mm, 6.0 mm, 30PD인 21명(3군)은 5.5 mm, 7.0 mm를 각각 시행하여 수술결과를 비교하였다. 수술 성공 기준은 원거리 및 근거리 사시각 모두 ±8PD 미만으로 하였다. 결과: 최소 6개월 이상의 추적관찰 후 최종 관찰시 수술성공률은 각각 84.0%, 88.0%, 90.4%였으며, 과교정된 경우는 없었다. 술 전 평균 근거리 입체시는 1군 108.3 ± 4.2초각, 2군 88.0 ± 5.2초각, 3군 63.3 ± 4.8초각이었고, 술 후에는 각각 100.4 ± 2.3초각, 81.5 ± 3.3초각, 60.6 ± 2.5초각으로 호전되었으나 유의한 차이는 없었다(p＞0.05). 술 전 평균 원거리 입체시는 1군 125.0 ± 6.3초각, 2군 117.0 ± 4.3초각, 3군 137.7 ± 3.3초각이었고, 술 후에는 각각 105.7 ± 3.2초각, 96.5 ± 3.1초각, 109.9 ± 3.1초각으로 술후에 유의한 호전을 보였다(p˂0.05). 결론: 20, 25, 30PD의 사시각을 가진 기본간헐외사시에서 내직근절제와 외직근후전 후 사시각에 따른 수술 결과는 차이가 없었고(p=0.08), 원거리 입체시는 향상되었다(p˂0.05).