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선천과 후천 외사시, 선천 눈떨림에서 외안근 고유수용체의 형태학적 차이
이승태,김승현,조윤애,Sung-Tae Yi,Seung-Hyun Kim,Yoonae A. Cho 대한안과학회 2005 대한안과학회지 Vol.46 No.11
Purpose: To evaluate morphological differences in proprioceptors in extraocular muscles between congenital exotropia, acquired exotropia and congenital nystagmus. Methods: Nine medial recti including the myotendinous junction were resected using medial rectus resection in three congenital and five acquired exotropia patients. Two medial recti and two lateral recti were resected using the modified Kestenbaum procedure in two congenital nystagmus patients. The muscle tissues were examined under a light microscope following examination with a transmission electron microscope. Results: In the congenital exotropia group, the electron microscopic findings showed degenerative changes in proprioceptors, such as decreased microtubules, axonal shrinkage and decreased myelin thickness. In the acquired exotropia group, the neural structures in the myotendinous junction were well maintained. There were no neural structures in the myotendinous junction in the congenital nystagmus group. Conclusions: Depending on the type of strabismus, there may be morphological differences in proprioceptors of extraocular muscles.
재발된 간헐외사시에서 순응도에 따른 부분가림치료의 장기적 효과
김상균,이승태,김승현,조윤애,Sang Kyoon Kim,MD,Sung-Tae Yi,MD,Seung-Hyun Kim,MD,PhD,Yoonae A,Cho,MD,PhD 대한안과학회 2009 대한안과학회지 Vol.50 No.1
Purpose: To evaluate the reoperation rate and the change of exo-angle according to compliance level of part time occlusion therapy in recurrent intermittent exotropia. Methods: This retrospective study included 52 patients of recurrent intermittent exotropia who followed up more than 5 years after their first operation. They were ordered part time occlusion therapy for recurrent exotropia. The patients were divided into 4 groups according to the level of compliance of part time occlusion therapy (\'excellent\', \'good\', \'fair\', \'poor\'). We evaluated the reoperation rate in 5 years after the first operation and the change of exo-angle from the early recurrent time according to compliance levels. Results: The reoperation rate within 5 years after the first operation of \'excellent\' and \'good\' compliance groups was lower than that of \'fair\' and \'poor\' groups (33.3, 26.3, 73.7 and 45.5% respectively) and the degree of exo-angle progression from the early recurrent time of the \'excellent\' and \'good\' compliance groups was less than that of \'fair\' and \'poor\' compliance groups, both results of which were statistically significant (p=0.02, 0.03). Conclusions: Part time occlusion therapy in recurrent intermittent exotropia has good long-term effects of decreasingreoperation rates in patients with a high level of compliance.
10년 이상 방치된 불변수평사시의 수술 후 입체시 회복
김수,이승태,조윤애.Soo Kim. M.D.. Sung-Tae Yi. M.D.. Yoonae A. Cho. M.D.. Ph.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.11
Purpose: To evaluate postoperative binocularity after surgical correction of longstanding constant-horizontal adult strabismus without both stereopsis and previous surgery. Methods: Subjects included 43 adults over 18 years of age, who had constant-horizontal strabismus for more than 10 years without previous surgery and stereopsis. The patients were composed of 30 exotropes and 13 esotropes. Patients with a corrected visual acuity less than 20/40 in the deviating eye were excluded. After correcting for refractive error, the angle of deviation was measured, and pre- and postoperative stereopsis was assessed with the Titmus fly test? and Randot stereo test. The relationship between duration of deviation and recovery of stereopsis or obtained stereoacuity were evaluated. Results: The mean preoperative angle of deviation was 49.8±12.56 PD in exotropes and 34.7±12.41 PD in esotropes. All patients showed suppression of the deviating eye at distance and near before surgery. Postoperatively all patients showed orthophoria within ±8 PD. Stereopsis was obtained in 80% of exotropes and in 30.8% of esotropes. The mean postoperative stereoacuity was 449.2±815.29 seconds of arc (sec) in exotropes and 1000±1336.66 sec in esotropes. However, there was no significant relationship between the duration of deviation and the obtained stereoacuity (p>0.05), or between the duration of deviation and the recovery of stereopsis (p>0.05). Conclusions: Adults with longstanding constant-horizontal strabismus more than 10 years obtained stereopsis with good quality after surgical correction. The recovery of stereopsis was much better in exotropes than in esotropes. Recovery was not influenced by the duration of deviation.