간헐외사시 수술 후의 장기 성적: 운동기능과 감각기능 성과에 영향을 미친 인자의 분석

초록

Purpose: To evaluate the long-term surgical success rate (>3 years) and contributing success factors considering motor andsensory criteria for patients with intermittent exotropia.Methods: Fifty-four patients who received surgery for intermittent exotropia and were followed-up for a minimum of 3 years, includingreoperation, were retrospectively evaluated. The first procedure was unilateral recession and resection in 50 patientsand bilateral lateral rectus recession in 4 patients. Patients were classified as achieving a good, fair or poor outcome based onmotor and sensory criteria. Success rate and associated factors such as postoperative alignment, exotropia type, first surgicalprocedure, and proportion of patients receiving reoperations were analyzed.Results: The mean follow-up period after the first surgery was 4.81 ± 1.30 years. The good outcome was achieved in 32 patients(59.3%), fair in 14 patients (25.9%), and poor in 8 patients (14.8%) considering motor criteria only. The good outcome was achievedin 29 patients (51.9%), fair in 12 patients (22.2%), and poor in 14 patients (25.9%) when considering combined motor/sensory (functional) criteria. No patient who received bilateral lateral rectus recession as the first procedure belonged to thegood outcome group (p = 0.03 by motor criteria and p = 0.044 by functional criteria). Patients who received reoperation were significantlymore likely to be in the good and fair groups (p = 0.009 by motor criteria and p = 0.02 by functional criteria).Conclusions: Long-term surgical results of intermittent exotropia in this Korean population revealed 85.2% motor success rate and74.1% functional success rate. Early postoperative overcorrection was not associated with long-term success. Recession and resectionprocedure and reoperations were significantly associated with better outcome based on motor and functional criteria. Diligentreoperations after the first surgery could possibly contribute to good long-term functional outcome in intermittent exotropia patients.

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