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목적: 간헐외사시수술 후 근거리 작업이 지연발현 속발내사시 발생에 미치는 영향을 알아보고자 한다. 대상과 방법: 2019년 1월부터 2020년 1월까지 외래 내원한 환자 중 간헐외사시로 양안 외직근후전술을 시행 받고 정위를 회복한 후다시 내편위가 발생한 지연발현 속발내사시 환자들(1군)과 정위 회복 후 3년간 내사시가 발생한 적이 없는 환자들(2군)을 대상으로술 후 하루 근거리 작업 시간 등을 설문 조사하였다. 결과: 총 42명의 환자가 포함되었다. 수술 전 원거리 사시각은 1군 28.5 ± 4.4 prism diopters (PD) 대조군은 30.5 ± 5.2 PD, 근거리사시각은 1군 29.3 ± 4.8 PD, 2군 31.6 ± 6.0 PD로 유의한 차이를 보이지 않았다. 하루 두 가지 이상의 초근거리 작업을 하고 있는경우 통계적으로 유의하게 1군에서 많았다(1군 47.8%, 2군 15.8%, p=0.02). 2군에서는 TV 시청이 12명(63.2%)으로 1군과 비교하여통계적으로 유의하게 많았다(1군 6명 26.1%, p=0.02). 초근거리 작업 시간의 경우 하루에 1군 2.7 ± 2.1시간, 2군은 1.5 ± 1.2시간으로유의한 차이가 있었다(p=0.037). 결론: 양안 외직근후전술 후 지연발현 속발내사시가 발생한 환자들의 가림치료 종료 후 초근거리 작업의 빈도 및 시간은 술 후 내사시가 발생한 적이 없는 환자들에 비해 유의하게 높았다. 술 후 환자 및 보호자에게 초근거리 작업의 주의가 고려되어야 하겠다.
Purpose: To identify the correlation between near work and the occurrence of delayed-onset consecutive esotropia after surgery for intermittent exotropia. Methods: A survey and retrospective review were conducted on patients in two groups. The study included patients who visited from January 2019 to January 2020. Patients who re-developed esodeviation after recovering orthophoria after the initial postoperative overcorrection for the surgical correction of intermittent exotropia were included in the delayed-onset esotropia group (Group 1), and patients with persistent orthotropia for at least 3 years after bilateral lateral rectus recession for intermittent exotropia were included in Group 2. We evaluated the daily frequency and hours of distance/near work in both groups. Results: A total of 42 patients were evaluated. Preoperative exodeviation at a distance was 28.5 ± 4.4 prism diopters (PD) in group 1 and 30.5 ± 5.2 PD in group 2, with no significant difference between the two groups. The percentages of patients who chose two or more extremely near-work activities a day were 47.8% and 15.8% for groups 1 and 2, respectively; these values were statistically significant (p = 0.02). Twelve patients in Group 2 answered “watching TV” (63.2%) as the most common activity, which was statistically significant compared to Group 1 (26.1% in Group 1, p = 0.02). The total numbers of hours of extremely near-work a day were 2.7 ± 2.1 and 1.5 ± 1.2 hours for groups 1 and 2, respectively, which was also statistically significant (p = 0.037). Conclusions: We found a significant correlation with occurrence of delayed-onset consecutive esotropia with the frequency and hours of extremely near-work after bilateral lateral rectus recession for intermittent exotropia. More attention to extremely near-work should be considered carefully after bilateral lateral rectus recession for intermittent exotropia.
