Surgical Outcome of Sensory Exotropia with Distant-Near Disparity

Hun Jae Won, Dae Hee Kim, Hyun Taek Lim
2015 Journal of the Korean Ophthalmological Society  
Purpose: To assess clinical features of sensory exotropia with distant-near disparity, surgical outcome, and compare according to amount of medical rectus resection. Methods: Authors retrospectively reviewed medical records of patients of sensory exotropia with follow-up over 6 months. We defined patients with over 10 prism diopter (PD) disparity as distant-near disparity sensory exotropia (DND-XT) and without disparity as basic sensory exotropia (B-XT). First, we analyzed and compared data of
more » ... isual acuity, cause and age of visual loss, amount of deviation. Second, Surgical failure was analyzed with dividing DND-XT into conventional surgery group as Parks' formula and reduced medial rectus resection group in accordance with disparity. Surgical success was defined as less than 10 PD deviation in distant, near fixation. Results: B-XT consisted of 58 patients (40 males) and DND-XT of 33 patient (13 males). There was no significant difference between 2 groups in onset and cause of visual loss, deviation at distant fixation. But, log MAR visual acuity of worse eye was better in DND-XT than B-XT (1.74 ± 0.78, vs. 2.10 ± 0.74, p = 0.039). Average deviation in distant fixation in DND-XT was 46.55 ± 16.59 PD in distant and 14.93 ± 8.91 PD in near fixation. All patients underwent surgery of medial rectus resection and lateral rectus recession and average deviation was 6.83 ± 7.71 PD at distant fixation, 3.02 ± 0.69 PD at near fixation at last follow-up. Among 33 patients, 16 patients underwent conventional amount of surgery and 17 patients with reduced medial rectus resection. In patient with conventional surgery, 9 patients were surgical failure (8 patients of over-, 1 patient of under-correction) but in patient with reduced amount of resection, only 1 patient was under-correction. Conclusions: As a result of medial rectus resection and lateral rectus recession in DND-XT, more surgical failures due to over-correction were observed with conventional resection and higher surgical success was attained in consideration of disparity. ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 한 눈의 시력이 손상되면 감각 융합이 파괴됨으로써 사 시가 발생할 수 있는데, 이를 감각 사시(sensory strabismus) 라 한다. 1 감각 이상은 원추 각막, 2 노인성 백내장 3 등의 전 안부 이상, 유리체 출혈 등의 망막 질환, 4 굴절 이상, 5 선천 이상 6 등에 의해 발생할 수 있다. 감각 사시는 5-6세 전에는 내사시와 외사시가 비슷한 비율로 발생하며, 그 이후에는 외사시가 주로 발생하는 것으로 알려져 있다. 1,7-9 감각 사시의 치료로는 일반적으로 프리즘안경, 수술을 포함한 몇 가지 방법이 이용되고 있으나 주요 치료법은 외 안근 수술이다. 10-15 감각외사시에 대해서는 사시안의 내직
doi:10.3341/jkos.2015.56.10.1599 fatcat:poxltsl37rcldd3mxdc7iyf6iq