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목적 : To describe characteristics of recurrent intermittent exotropia after bilateral lateral rectus recession (BLR), and identify factors associated with poor outcome after medial rectus resection for recurrent intermittent exotropia.
방법 : We retrospectively reviewed 92 patients who have undergone medial rectus resection for recurrent intermittent exotropia after BLR. Patients were followed for at least 3 months after medial rectus resection. Clinical characteristics were compared between patients who showed poor outcome against those with satisfactory outcome. Risk factors associated with poor outcome after medial rectus resection were also evaluated. Successful outcome was defined as distant deviation within the range of 4 prism diopters(PD) esotropia and 10 PD exotropia at last visit after medial rectus resection.
결과 : Of 92 patients(8.6±2.2years old at recurrence, 44.6% male) who received medial rectus resection for recurrent intermittent exotropia, 26 patients(28.3%) showed poor outcome(10.7±5.4PD exotropia at last follow-up). Patients were followed for 73.6±27.3months. The two groups began to significantly differ in deviation 3 months after medial rectus resection(7.5±6.0PD vs. 1.5±2.7PD, P<0.001). At 3 months’ follow-up, 57.7% of poor outcome group showed deviation greater than 8 PD exotropia at distance(n=15) in comparison to 6.1% of the successful outcome group (n=4).
결론 : Follow-up deviation 3 months after medial rectus resection for recurrent intermittent exotropia may play a valuable role in anticipating poor outcome. Patients whose exotropia exceeded 8 PD at distance at 3 months follow-up tended to recur while those whose exotropia remained below 8 PD at distance showed a stable disease course. No baseline clinical characteristics distinguished poor outcome group from the successful outcome group.
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