듀안안구후퇴증후군의 얼굴돌림과 내전시 과도한 상하전에 대한 수술적 치료

• 영문명: Surgical Treatment of Face Turn, and Up and Down Shoot in Duane Retraction Syndrome
• 발행기관: 대한안과학회
• 저자명: 오현주 문성혁 김명미,Oh Hyun Ju, MD, Sung Hyuk Moon, MD, Myung Mi Kim, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume54,number6, 927~931쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2013.06.15

영문 초록

Purpose: To present the results of patients undergoing surgical treatment and determine clinical guidelines for the face turn, and up and down shoot in Duane retraction syndrome (DRS). Methods: Thirty-four patients with DRS were treated with single horizontal rectus muscle recession, lateral rectus (LR) recession with Y-splitting, or LR recession with Y-splitting combined with medial rectus (MR) recession. The different treatment approaches were based on the angle of deviation in the primary position, versions, and ductions. In all patients, ocular alignment, face turn and up and down shoot were assessed preoperatively and postoperatively. Results: The average standard deviation reduced from 18.5 ± 6.5 prism diopters (PD) to 4.6 ± 5.8 PD in horizontal rectus muscle recession and 14.4 ± 5.5 PD to 1.6 ± 2.8 PD in LR recession with Y-splitting. LR recession with Y-splitting combined with MR recession was effective in reducing globe retraction. Postoperative 4-mm LR recession with Y-splitting did not change ocular alignment; 7-mm LR recession with Y-splitting showed an average correction of 12.8 PD. Postoperatively, all patients presented a reduction in face turn; however, there was no statistically significant difference between the 2 procedures (Mann-Whitney U test, p = 0.620). Conclusions: Decisions regarding surgical approaches in DRS should be based on the amount of deviation in primary eye position, the expression of up and down shoot, and the degree of face turn. Surgeons planning Y-splitting of LR with MR recession must consider modifying the MR recession amount due to the smaller LR recession effect of Y-splitting compared with conventional LR recession.

키워드

Duane retraction syndrome, Face turn, Recession, Y-splitting