외직근 후전을 시행한 간헐 외사시 환자에서 술 후 초기 사시각의 변화

Short-Term Changes of Immediate Postoperative Deviation after Lateral Rectus Recession for Intermittent Exotropia

Purpose: To assess the prevalence of short-term changes in immediate postoperative deviation, and to evaluate the relationship of these to clinical factors after lateral rectus recession for intermittent exotropia. Methods: One hundred patients who had lateral rectus recession performed for intermittent exotropia and who had at least 3 months of postoperative follow-up were included in this study. Results: The average angle of esodeviation on postoperative day 1 was 8.2 (-5～+25) △. The rate of surgical success (≤8△exodeviation～≤5△esodeviation) at postoperative 3 months was highest in the group of patients with 10～15△ esodeviations (p=0.06). Patients under 10 years old had greater esodeviation (9.7△) on postoperative day 1 than patients 10 years and older (4.9△) (p=0.00). They also had more exotropic drift over a 3-month postoperative period (p=0.00). There was a negative correlation between age and esodeviating angle (correlation coefficient=-0.36). Patients 10 years and older who were overcorrected ≥10△ on postoperative day 1 showed a higher chance of surgical failure due to overcorrection at postoperative 3 months (p=0.002). The preoperative deviating angle, type of exotropia, and combined oblique muscle surgery did not influence the outcome. Conclusions: An esodeviation of 10～15△ on postoperative day 1 was related to a good outcome at postoperative 3 months. Less esodeviation and smaller exotropic drift occurred in patients aged 10 years and older, so it is possible that an initial overcorrection of ≥10△ may remain for a long period of time in the older patient group.