수술 후 속발내사시각이 수술 전 외사시각보다 큰 환자의 임상 경과 Clinical Course of Patients with Consecutive Esotropia Angle Larger Than Preoperative Angle After Exotropia Surgery원문보기
목적: 외사시 수술 후 1일째 수술 전 외사시 각도 이상으로 심한 내사시가 된 환자들의 경과를 알아보았다. 대상과 방법: 외사시 수술 후 1일째 내사시각이 수술 전 외사시각 이상으로 큰 환자를 대상으로 하였으며, 외직근이 소실된 경우는 제외하였다. 수술 전 임상 특징과 수술 후 내사시의 경과를 조사하였으며, 수술 전후 양안시를 비교하였다. 결과: 13명의 수술 전 평균 외사시각은 원거리에서 23프리즘디옵터(PD), 근거리에서 27PD이었으며, 외측불일치가 9명 있었다. 수술 후 1일째 평균 내사시각은 원거리에서 27PD, 근거리에서 25PD이었다. 모든 환자에서 교대가림을 하였으나, 3명에서 10PD 미만으로 내사시가 감소하였다. 모든 환자에서 프레넬프리즘 착용 후 4명은 정위가 되었으며, 다른 4명은 8PD 이내의 프리즘안경이 계속 필요하였다. 나머지 5명은 12PD 이상의 내사시가 지속되었고, 64%에서 수술 전보다 수술 후 양안시가 저하되었다. 결론: 외사시 수술 후 1일째 내사시각이 수술 전 외사시각 이상으로 큰 경우 외측불일치의 빈도가 높았다. 모든 환자에서 교대가림과 프레넬프리즘 치료를 하였으나, 정위 및 양안시의 예후는 비교적 불량하였다.
목적: 외사시 수술 후 1일째 수술 전 외사시 각도 이상으로 심한 내사시가 된 환자들의 경과를 알아보았다. 대상과 방법: 외사시 수술 후 1일째 내사시각이 수술 전 외사시각 이상으로 큰 환자를 대상으로 하였으며, 외직근이 소실된 경우는 제외하였다. 수술 전 임상 특징과 수술 후 내사시의 경과를 조사하였으며, 수술 전후 양안시를 비교하였다. 결과: 13명의 수술 전 평균 외사시각은 원거리에서 23프리즘디옵터(PD), 근거리에서 27PD이었으며, 외측불일치가 9명 있었다. 수술 후 1일째 평균 내사시각은 원거리에서 27PD, 근거리에서 25PD이었다. 모든 환자에서 교대가림을 하였으나, 3명에서 10PD 미만으로 내사시가 감소하였다. 모든 환자에서 프레넬프리즘 착용 후 4명은 정위가 되었으며, 다른 4명은 8PD 이내의 프리즘안경이 계속 필요하였다. 나머지 5명은 12PD 이상의 내사시가 지속되었고, 64%에서 수술 전보다 수술 후 양안시가 저하되었다. 결론: 외사시 수술 후 1일째 내사시각이 수술 전 외사시각 이상으로 큰 경우 외측불일치의 빈도가 높았다. 모든 환자에서 교대가림과 프레넬프리즘 치료를 하였으나, 정위 및 양안시의 예후는 비교적 불량하였다.
Purpose: To report the clinical course of severe consecutive esotropia (ET) with an esotropic angle at postoperative day 1 larger than the preoperative exotropia angle (XT). Methods: Patients with ET angles at postoperative 1 day greater than their preoperative XT angles were included; the case of l...
Purpose: To report the clinical course of severe consecutive esotropia (ET) with an esotropic angle at postoperative day 1 larger than the preoperative exotropia angle (XT). Methods: Patients with ET angles at postoperative 1 day greater than their preoperative XT angles were included; the case of lost lateral rectus during surgery was excluded. Preoperative clinical characteristics and the course of postoperative alignment were analyzed, and binocularity was compared between the preoperative state and the postoperative state. Results: The mean preoperative angle of XT of 13 patients was 23 prism diopters (PD) at distance and 27PD at near. Lateral incomitancy was observed in 9 patients. One day postoperatively, the mean angle of ET was 27PD at distance and 25PD at near, and alternate occlusion therapy was performed in all patients. However, the angle of ET was decreased 10PD or less in only 3 patients. All 13 patients were managed with Fresnel prisms, and 4 patients had orthotropia. Another 4 patients used glass prisms because they had ET of 8PD or less, and the remaining 5 patients still showed an ET with 12PD or more. Binocularity after surgery was worse than that before surgery in 64% of patients. Conclusions: For patients with ET angles at postoperative 1 day greater than preoperative XT angles, the frequency of lateral incomitancy was high. Alternate occlusion and Fresnel prism treatment were needed in all patients. Recovery from orthotropia and the prognosis of binocularity were relatively poor.
Purpose: To report the clinical course of severe consecutive esotropia (ET) with an esotropic angle at postoperative day 1 larger than the preoperative exotropia angle (XT). Methods: Patients with ET angles at postoperative 1 day greater than their preoperative XT angles were included; the case of lost lateral rectus during surgery was excluded. Preoperative clinical characteristics and the course of postoperative alignment were analyzed, and binocularity was compared between the preoperative state and the postoperative state. Results: The mean preoperative angle of XT of 13 patients was 23 prism diopters (PD) at distance and 27PD at near. Lateral incomitancy was observed in 9 patients. One day postoperatively, the mean angle of ET was 27PD at distance and 25PD at near, and alternate occlusion therapy was performed in all patients. However, the angle of ET was decreased 10PD or less in only 3 patients. All 13 patients were managed with Fresnel prisms, and 4 patients had orthotropia. Another 4 patients used glass prisms because they had ET of 8PD or less, and the remaining 5 patients still showed an ET with 12PD or more. Binocularity after surgery was worse than that before surgery in 64% of patients. Conclusions: For patients with ET angles at postoperative 1 day greater than preoperative XT angles, the frequency of lateral incomitancy was high. Alternate occlusion and Fresnel prism treatment were needed in all patients. Recovery from orthotropia and the prognosis of binocularity were relatively poor.
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