내시경적 부비동 수술 시행 후 내직근 절제로 발생한 외사시를 1년이 지난 시점에서 수술적 치료를 통하여 교정한 1예

• 영문명: Sequential Correction for Large Exotropia: A Case of Iatrogenic Exotropia Developed after Excision of Medial Rectus Muscle During Functional Endoscopic Sinus Surgery (FESS)
• 발행기관: 대한안과학회
• 저자명: 유애리 임혜빈,Ae Ri Yoo, MD, Hye Bin Yim, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume54,number2, 375~381쪽, 전체 7쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2013.02.28

영문 초록

Purpose: To report a case of iatrogenic exotropia caused by accidental excision of medial rectus muscle during functional endoscopic sinus surgery (FESS), which was successfully corrected by sequential surgical intervention (superior and inferior rectus muscle transposition followed by lateral rectus muscle recession). Case summary: Forty one year old male patient visited our clinic with large exotropia of the right eye developed after functional endoscopic sinus surgery (FESS) which was performed one year ago. At the initial visit in our clinic, there was a large exotropia (95 PD) of the right eye and transection of the medial rectus muscle was observed at the orbital MRI. In order to correct this large iatrogenic exotropia, sequential surgery was planned. Initially, full-tendon transposition of the right superior and inferior rectus muscle was performed which reduced the deviation to 35 PD. Six weeks after the initial surgery, 7 mm right lateral rectus muscle recession was additionally performed, which resulted in exotropia of 10 PD. Diplopia was also improved and the patient was esthetically satisfied with the result. Conclusions: Even in a case of iatrogenic exotropia following one year after an accidental excision of medial rectus muscle during intranasal sinus surgery, sequential surgery such as transposition of superior and inferior rectus muscle followed by lateral rectus muscle recession can result in satisfying cosmetic and functional improvement.

키워드

Endoscopic sinus surgery, Exision of extraocular muscle, Full-tendon transposition, Iatrogenic exotropia, Sequential strabismus surgery