乳児内斜視における術後屈折異常の眼位への影響

Effect of management of refractive anomaly on ocular alignment following surgery for infantile esotropia

要約　目的：乳児内斜視の術後に安定した眼位を保つために，屈折の管理が持つ意義の検討。対象と方法：過去11年間に内斜視手術を行った8歳未満の43症例を検索した。術後の屈折は調節麻痺下で行った。屈折を未矯正または矯正の状態で，眼位を交代プリズムカバーテストで計測した。結果：術後の屈折値は，球面等価度数で平均＋1.27Dであった。眼位は屈折未矯正時で平均＋5.37Δ，完全矯正時で平均＋1.28Δで，完全矯正時では有意に減少して正位に近づいた。調節性内斜視が9例（21％）にあった。結論：乳児内斜視の術後では，屈折管理を行うことが良好な眼位と両眼視機能獲得のために重要である。

Abstract.　Purpose：To evaluate the importance of management of refractive anomaly on ocular alignment following surgery for infantile esotropia. Cases and Method：This retrospective study was made on 43 patients who received surgery for esotropia surgery at the age of 8 years or less during the foregoing 11 years. State of refraction was measured under cycloplegia. Eye position was recorded by alternate prism cover test under uncorrected and corrected anomaly of refraction. Results：Postoperative refraction averaged spherical equivalent of ＋1.28Δ. Eye position averaged ＋1.28Δ with full refractive correction and ＋5.37Δ without. The difference was significant. Accommodative esotropia was present in 9 cases（21％）. Conclusion：Proper management of refraction is essential in ocular alignment and binocular vision following surgery for infantile esotropia.