소아 눈모음부족외사시에서 근거리/원거리 사시각에 따른 단안 절제술 및 후전술

Unilateral Resection-Recession Based on Near/Distance Deviation in Children with Exotropia of the Convergence Insufficiency Type

Purpose: The purpose of this study was to evaluate prospectively the long-term surgical results of unilateral lateral rectus (LR) muscle recession and medial rectus (MR) muscle resection in children with convergence insufficiency exotropia (XT). Methods: This prospective study included 14 children with an angle of XT greater at near than at distance by 10 prism diopters (PD) or more. The amounts of resection and recession were based on near and distance deviation, respectively. Minimum follow-up was one year (mean, 26.6±19.4 months) after surgery. Results: Significant postoperative reduction was achieved in mean distance exodeviation from 22.5 PD to 9.1 PD (p=0.000), and in mean near exodeviation from 33.8 PD to 13.6 PD (p=0.000). The mean near-distance difference decreased from 11.3 PD preoperatively to 4.6 PD postoperatively (p=0.000). A Fresnel prism was used temporarily to treat postoperative esotropia in only one patient for 6 months postoperatively. Conclusions: Unilateral surgery biased more to MR strengthening than to LR weakening in children with convergence insufficiency XT, was found to successfully reduce both distance and near deviation and to collapse near-distance differences with a low risk of long-term postoperative esotropia.