| Surgical Treatment of Intermittent Exotropia. |
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Yoon Ae Cho, Han Seop Shin, Han Soo Joo, Hai Ryun Jung |
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Department of Ophthalmology, Korea University, College of Medicine, Seoul, Korea. |
| 간헐성 외사시의 수술료법에 관한 고찰 |
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조윤애(Yoon Ae Cho),신한섭(Han Seop Shin),주한수(Han Soo Joo),정해륜(Hai Ryun Jung) |
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| Abstract |
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Intermittent exotropia at times is completely controlled by the convergence mechanisms and at other times escapes this control and becomes a manifest exotropia. The treatment of choice is surgical and the treatment is directed at normalization of binocular functions, and recurrence and overcorrection are frequently seen after surgery. Therefore it is important to decide the time and the type of surgery. The author experienced 66 cases of intermittent exotropia in which surgery was done. Surgery was indicated in the cases with deviation of 20 PD or more, deviation of less than 20 PD with asthenopia, exotropia occurred during more than 40% of waking hours, and deterioration of stereoacuity even at early age. Bilateral recession was initial procedure regardless type of intermittent exotropia. In the case with amblyopia, however, R and R was done on the amblyopic eye and in convergence insufficiency type bimedial resection. Lateral Incomitancy was present in 37.9%. The basic type which was shown in 68.2% was the most frequent one. The amount of esodeviation was 15 to 10 PD in 43.9% and 11 to 15 PD in 21.2% on the first postoperative day. The phoria within 10 PD was shown in 95.4% 6 weeks after surgery, in 98.5% 3 months after surgery, and in 93.9% 6 months after surgery. Six months after surgery, 4 cases revealed exodeviation above 16 PD and no case esodeviation. Stereopsis was tested in 54 cases who understood the test before operation and 43 cases(79.6%) showed stereopsis. Nine out of 11 cases who had no stereopsis showed stereopsis after operation. In this study, success rate of first surgery was as high as 93.9% in 6 months follow-up and stereopsis was restored in considerable number of cases in intermittent exotropia compared to other types of strabismus and binocular function could also be restored and improved after surgery. |
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