Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
권호 표지

The Change in Deviation Angle with Time Course after Surgical Correction of Intermittent Exotropia

간헐외사시 수술 후 시간에 따른 사시각 변화에 대한 연구

Hahm, Kyoung-Hoon;Shin, Min-Cheol;Sohn, Mi-Ah
함경훈;신민철;손미아

  • Published : 20021100
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Abstract

Purpose: To evaluate the amount and pattern of change in deviation angle with time course after surgical correction of intermittent exotropia and to evaluate the effect of pre-operative deviation and operation age on post-operative deviation change. Methods: 54 patients who followed more than 60 months (60${\sim}$120 months, mean 71.7 months) after surgical correction of intermittent exotropia were selected. We defined 'satisfactory results' that alignment of orthotropia, under 10$\triangle$ esotropia and under 10$\triangle$ exotropia. Results: Of 54 patients, satisfactory results obtained in 96.2%(52 patients), immediate post-operation day and decreas with time course to 35.1% (19 patients) at post-operative 5 years. To quantification of change of deviation, author defined exotropic drift as +, esotropic drift as -, and no change as O. The change of deviation between immediate post-operation and 2 years after operation is +14.55$\triangle$, between 2 years after and 5 years is +2.70$\triangle$. The change of deviation developed between immediate post-operation and 2 years after operation has statistical significance in comparison with change of deviation developed between after 2 years and 5 years after operation (P=0.0001). Pre-operative deviation has no effect on post-operative deviation change (P=0.4472) and operation age was same (P=0.3461). Conclusions: The results of surgical correction of intermittent exotropia is significantly deteriorated with time course. Exotropic drift was more pronounced between immediate post-operation and 2 years after operation and then decreased. Therefore we recommend that after surgery of intermittent exotropia patients should be followed by schedule more than 2 years and thereafter the tendency for exotropic drift will more stable. After 2 years, however, small amount exotropic drift can be possible.

목적 : 간헐외사시 수술 후 시간의 경과에 따른 사시각의 변화를 알아보고 수술시 연령, 술전 사시각이 술후 사시각의 변화에 미치는 영향을 알아보고자 하였따. 대상과 방법 : 본원에서 간헐외사시로 수술 받고 60개월 이상 추적 관찰(60${\sim}$120개월, 평균 71.7개월)이 가능했던 54명의 환자를 대상으로 하였다. 결과 : 사시각이 정위, 10$\triangle$이내의 과교정 EH는 부족교정을 만족스러운 결과로 볼 때 수술 직후(수술후 1${\sim}$2일)에 96.2%에서 만족스러운 결과를 보였으며 60개월에 35.1%에서 만족스러운 결과를 보였다. exotropic drift를 +, esotropic drift를 -로 하여 기간에 따른 사시각의 변화를 보면 수술후 2년 이내에 발생한 사시각 변화가 +14.55$\triangle$으로 수술 후 2년 이후부터 5년 사이에 발생된 +2.70$\triangle$의 변화와 비교하여 통계학적으로 유의하였다(P=0.0001). 수술시 연령(P=0.3461), 술전 사시각(P=0.4472)은 수술 후 사시각 변화에 유의한 영향을 미치지 않았다. 결론 : 간헐외사시 수술 후 60개월 이상 장기 추적 관찰에서 수술 후 2년 이내의 사시각의 증가가 두드러지게 나타났다. 따라서 간헐외사시 수술 후 사시각의 안정화를 기대하려면 최소한 2년 이상의 추적 관찰이 필요하다고 생각되며 앞으로 좀 더 많은 환자군에 대한 전향적인 장기 추적 관찰 결과가 필요하리라 사료된다.

Keywords

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