공막노출법으로 익상편 제거술을 시행 받은 환자에서 발생한 내사시의 임상양상과 치료

Clinical Characteristics and Treatment of Esotropia Following Bare Sclera Pterygium Surgery

Purpose: The clinical features of esotropia after bare scleral pterygium surgery and dipolpia treatment results were evaluated in the present study. Methods: Twenty eyes of 12 patients who had esotropia after bare sclera pterygium surgery from 2008 to 2011 were retrospectively investigated. Results: Diplopia occurred at 2.8 ± 1.6 months (1-6 months) after pterygium surgery. The mean pre-operative angle of esotropia was 19.4 ± 8.9 PD (8-40 PD) at distance and 16 ± 7.3 PD (0-30 PD) at near. All patients showed limitation of abduction in the pterygium operated eye. Two patients were prescribed prism glasses, 2 patients underwent conjunctiva surgery, and medial rectus recession with simultaneous intraoperative adjustment surgery was performed in 8 patients. An additional strabismus operation was required for 2 patients who received conjunctival surgery due to diplopia recurrence. Seven patients (70%) showed orthotropia at 3 months. Conclusions: In this study, diplopia following postoperative adhesion caused by bare sclera pterygium surgery technique was observed. Conjunctiva-perimuscular scar tissue removal and medial rectus recession were effective methods in eliminating diplopia.