J Korean Ophthalmol Soc > Volume 57(7); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(7):1134-1138.
DOI: https://doi.org/10.3341/jkos.2016.57.7.1134    Published online July 15, 2016.
Unilateral Lateral Rectus Muscle Advancement Surgery Based on One-fourth of the Angle of Consecutive Esotropia.
Jung Yup Kim, Soo Jung Lee
Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. kris9352@hanmail.net
속발 내사시에서 수술량을 내사시각의 1/4만큼 시행한 한눈 외직근 전진 수술의 효과
김중엽⋅이수정
인제대학교 의과대학 해운대백병원 안과학교실
Abstract
PURPOSE
To evaluate the efficacy of unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia within 25 prism diopters (PD) which occurred after bilateral lateral rectus muscle recession for intermittent exotropia. METHODS: Medical records of 11 patients who underwent unilateral lateral rectus muscle advancement for consecutive esotropia from 2011 to 2014 and who were observed for at least 6 months after surgery were retrospectively reviewed. The change in the angle of deviation before and after consecutive esotropia surgery, success rate, and surgical effect were evaluated. RESULTS: Preoperative esodeviation was -19.6 ± 4.7 PD at distance and -16.5 ± 7.4 PD at near. Unilateral lateral rectus muscle advancement surgeries were performed based on one-fourth of the angle of consecutive esotropia and the mean surgical amount was 4.8 ± 1.1 mm. Of the total 11 patients, 10 patients (91%) recovered to orthotropia or exodeviation within 8 PD. One patient had a recurrence of esotropia at postoperative 3 months, but the patient recovered to orthotropia at postoperative 12 months with alternative patch treatment and a prism glass prescription. The surgical effect of unilateral lateral rectus muscle advancement was 3.3 ± 0.7 PD/mm at postoperative 1 day, 3.7 ± 0.6 PD/mm at postoperative 1 week, and 3.8 ± 0.7 PD/mm at postoperative 6 months. CONCLUSIONS: Unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia within 25 PD was successful in all 11 cases. The surgical effect was significantly greater in unilateral lateral rectus muscle advancement than in primary lateral rectus muscle recession. Thus, reduction in the amount of surgery should be considered carefully in unilateral lateral rectus muscle advancement for consecutive esotropia.
Key Words: Consecutive esotropia;Surgical effect;Unilateral lateral rectus muscle advancement


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