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Factors influencing the result of superior oblique weakening procedures in patients with superior oblique overaction in horizontal strabismus : 수평사시가 동반된 상사근기능항진 환자에서 상사근 약화술 결과에 영향을 미치는 인자

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dc.contributor.advisor김성준-
dc.contributor.author전준우-
dc.date.accessioned2021-11-30T04:51:43Z-
dc.date.available2021-11-30T04:51:43Z-
dc.date.issued2021-02-
dc.identifier.other000000164576-
dc.identifier.urihttps://hdl.handle.net/10371/176050-
dc.identifier.urihttps://dcollection.snu.ac.kr/common/orgView/000000164576ko_KR
dc.description학위논문 (석사) -- 서울대학교 대학원 : 의과대학 의학과, 2021. 2. 김성준.-
dc.description.abstractBackground: Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with horizontal strabismus. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction.

Methods: The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with horizontal strabismus who were treated with a superior oblique weakening procedure (superior oblique posterior tenectomy or superior oblique suture spacer) at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. The following data were collected: preoperative and postoperative superior oblique overaction, angle of deviation at a distance, stereopsis. Surgical success was defined as the complete absence of superior oblique overaction 1 month after surgery. Failure of operation was defined as the incomplete reduction or elimination of superior oblique overaction after surgery. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Also to investigate factors influencing the surgical result, the following data were collected: Surgical results of associated horizontal strabismus, surgical success rate according to the grade of superior oblique overaction, comparison by surgical method, comparison of unilateral group and bilateral group, comparison of the success group and failure group.

Results: Horizontal strabismus procedure was successful in 31 patients (83.8%) while failure was reported in 6 patients. Surgical success rate showed a trend of declining according to the grade of superior oblique overaction (p = 0.068). Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved in 13 (68.4%) eyes in the unilateral group and 25 (69.4%) eyes in the bilateral group. The surgical success rate of the superior oblique weakening procedure was 69.1% (38/55 eyes) in this study. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p < 0.001).

Conclusions: The surgical success rate of the superior oblique weakening procedure in the patients with superior oblique overaction associated with horizontal strabismus was 69.1% (38/55 eyes) which was similar to previous studies. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.
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dc.description.abstract배경 : 수평사시에 동반된 상사근기능항진 환자에서 상사근약화술의 결과에 대해서는 많은 연구가 있지 않다. 이 연구는 수평사시에 동반된 상사근기능항진 환자의 수술 결과에 영향을 미치는 인자에 대하여 알아보고자 하였다.

방법 : 2010년 1월에서 2017년 6월까지 서울대학교 병원에서 상사근 약화술(봉합사연장술, 뒤쪽힘줄절제술)을 시행한 수평사시 환자들 37명(55안)의 의무기록을 후향적으로 분석하였다. 수술 전후에 상사근기능항진정도, 원거리 수평사시각, 입체시에 대한 정보를 수집하였다. 수술 후 1개월째 상사근기능항진이 남지 않은 경우를 성공군, 상사근기능항진이 남아 있으면 실패군으로 정의하였다. 상사근 기능항진은 6단계로 +0.5에서 +3까지 0.5 단계로 구분하였으며 수술 전과 수술 후에 모든 환자의 기록을 분석하였다.
수술 결과에 영향을 미치는 인자를 알아보기 위해 다음과 같은 내용을 분석하였다. 동반된 수평사시각의 수술결과, 상사근기능항진 정도에 따른 수술 성공률, 수술 방법에 따른 비교, 단안군과 양안군에 대한 비교, 수술성공군과 실패군을 비교해 보았다.
결과 : 수평사시수술은 총 31명 (83.8%)에서 성공하였고 6명에서는 실패하였다. 상사근기능항진의 정도가 심할수록 수술 성공률이 떨어지는 경향을 보였다 (p = 0.068). 봉합사연장술군에서 수술 성공률은 15안 (65.2%)였고, 뒤쪽힘줄절제술군에서는 23안 (71.9%)였다. 단안군에서 수술 성공률은 13안 (68.4%)였고 양안군에서 수술 성공률은 25안 (69.4%) 였다. 총 55안 중 38안(69.1%)에서 상사근약화술이 성공하였다. 수술 성공군과 실패군을 비교하였을때 해리수직편위가 있는 경우 수술 성공률이 떨어지는 것을 발견할 수 있었다 (p < 0.001).

결론 : 69.1%(33/55안)에서 상사근약화술이 성공 하였고 이전에 보고된 결과들과 비슷한 결과를 보였다. 해리수직편위의 여부는 수술 성공에 영향을 미치는 것을 볼 수 있었다.
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dc.description.tableofcontentsIntroduction 1
Methods 2
1. Surgical methods 2
2. Inclusion and exclusion criteria 3
3. Patients characteristics 3
4. Statistical analysis 6
Results 6
1. Demographics 6
2. Surgical results of associated horizontal strabismus 6
3. Surgical success rate according to the grade of
superior oblique overaction 7
4. Comparison by surgical method 7
5. Comparison of unilateral group and bilateral group 7
6. Comparison of the success group and failure group 8
7. Stereopsis 8
Discussion 9
Conclusion 11
References 12
Abstract in Korean 19

Table
[Table 1] 14
[Table 2] 15
[Table 3] 16
[Table 4] 17
[Table 5] 18
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dc.format.extentv, 20-
dc.language.isoeng-
dc.publisher서울대학교 대학원-
dc.subjectSuperior oblique overaction-
dc.subjectSuperior oblique weakening procedure-
dc.subjectDissociated vertical deviation-
dc.subject상사근기능항진-
dc.subject상사근약화술-
dc.subject해리수직편위-
dc.subject.ddc610-
dc.titleFactors influencing the result of superior oblique weakening procedures in patients with superior oblique overaction in horizontal strabismus-
dc.title.alternative수평사시가 동반된 상사근기능항진 환자에서 상사근 약화술 결과에 영향을 미치는 인자-
dc.typeThesis-
dc.typeDissertation-
dc.contributor.AlternativeAuthorChun Jun Woo-
dc.contributor.department의과대학 의학과-
dc.description.degreeMaster-
dc.date.awarded2021-02-
dc.contributor.major안과학전공-
dc.identifier.uciI804:11032-000000164576-
dc.identifier.holdings000000000044▲000000000050▲000000164576▲-
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