40 프리즘디옵터 이상의 외사시에서 수술 전 예측한 수술 후 사시각의 정확성 = The Accuracy of Estimating Postoperative Deviation in Exotropia With over 40 Prism Diopters

다국어 초록 (Multilingual Abstract)

Purpose: To assess the accuracy of estimating postoperative deviation in large-angle exotropia over 40 prism diopters (PD). Methods: A retrospective analysis was performed on 61 exotropia patients with over 40 PD exotropia who had undergone 2-muscle surgery by two surgeons and with at least 6 months follow-up. The accuracy was assessed by analyzing the discrepancy between preoperatively predicted residual deviation and deviation at postoperative 6weeks. Successful surgery was defined as deviation within ± 10 PD at the last postoperative visit. Results: More accurate residual deviation was predicted in exotropia with prism diopters between 40 and 59 (97.8%) than in exotropia with 60 PD or more (62.5%). And there was no significant difference between two surgeons. Surgical success rates at six months and one year after surgery were 96.8%, 94.7% in exotropia with 40 to 49 PD, 71.4%, 60.0%, 50 to 59 PD, 50.0%, 45.5%, 60 PD or more, respectively. There were four patients of whom the postoperative deviation angle exceeded more than 10 PD of the estimated deviation. Conclusions: The accuracy of estimating residual deviation prior to surgery was higher and more successful surgery was achieved in exotropia ranging in 40 to 59 PD than in exotropia with 60 PD or more. Therefore, 2- muscle surgery will be suitable for large-angle exotropia with less than 60 PD. J Korean Ophthalmol Soc 2010;51(12):1614-1619

참고문헌 (Reference)

1 임성규, "사시각이 큰 외사시에서 양안 수술과 단안 수술의 효과" 대한안과학회 45 (45): 17-17, 2004

2 함경훈, "간헐외사시 수술 후 시간에 따른 사시각 변화에 대한 연구" 대한안과학회 43 (43): 21-2219, 2002

3 Kim JW, "The surgical treatment of exotropias of 60 prism diopters or more" 38 : 2200-2206, 1997

4 Scott WE, "The postoperative results and stability of exodeviations" 99 : 1814-1818, 1981

5 Park YG, "The effects of bilateral recti recessions over 8mm in exotropia over 40 prism diopters" 35 : 1123-1126, 1994

6 Park YH, "Surgical results of intermittent exotropia" 30 : 969-974, 1989

7 Livir-Rallatos G, "Surgical results in large-angle exotropia" 6 : 77-80, 2002

8 Azar RF, "Surgical management of exotropia exceeding 70 prism diopters" 3 : 159-166, 1971

9 Schwartz RL, "Surgery of large angle exotropia" 17 : 359-363, 1980

10 Thompson JT, "Ophthalmic prisms. Measurement errors and how to minimize them" 90 : 204-210, 1983

11 Kim MM, "Long - term surgical results of intermittent exotropia" 35 : 1321-1326, 1994

12 Urist MJ, "Exotropia with bilateral elevation in adduction. II. Surgery" 38 : 178-190, 1954

13 Lew HL, "Comparison of surgical results between bilateral rectus muscle recessions and lateral rectus muscle recession and medial rectus muscle resection in exotropia" 36 : 115-119, 1995

14 Lim HS, "Comparison of surgical results between bilateral rectus muscle recession and lateral rectus muscle recession and medial rectus muscle resection in exotropia over 40 prism diopters" 39 : 2810-2815, 1998

15 Wright KW, "Color atlas of ophthalmic surgery Strabismus 1st ed" Lippincott company 241-243, 1991

16 Kim SJ, "Clinical analysis of surgical results in exodeviation" 33 : 724-732, 1992