斜視手術既往症例の斜視手術

Surgical outcome in adults with past history of strabismus surgery

要約　目的：斜視手術の既往がある成人に行った斜視手術の報告。

対象と方法：過去10年間に当科で斜視手術を行った22例を対象とした。全例に他施設での斜視手術の既往があった。男性10例，女性12例で，年齢は20〜81歳，平均41歳である。

結果：当科受診時には，内斜視術後の外斜視が13例，外斜視術後の残余外斜視が6例，内斜視術後の残余内斜視が2例，外斜視術後の上下斜視が1例にあった。前回の斜視手術は，4〜60年前に行われていた。手術は原則として非手術眼または非手術筋に行い，10例では手術既往筋に行った。この10例中5例では，術前に既往筋ではないと推測し，術中に既往筋であったことが判明した。手術により8眼で正位が得られ，14眼で眼位異常が軽減した。22例すべてで整容的満足が得られた。

結論：斜視手術の既往がある22例に行った斜視手術で眼位異常が正常化または軽減した。斜視手術の既往筋は5例では術前に同定できなかった。

Abstract　Purpose: To report the surgical outcome in adults with past history of strabismus surgery.

Cases and Method: This retrospective study was made on 22 cases who received strabismus surgery by us during the past 10 years. All had history of surgery for strabismus in other institutions before. The series comprised 10 males and 12 females. The age at the initial visit to us ranged from 20 to 81 years, average 41 years.

Results: When seen by us, 13 cases had exotropia following surgery for esotropia, 6 had residual exotropia, 2 had residual esotropia, and one had vertical strabismus following surgery for exotropia. The previous surgery had reportedly been performed 4 to 60 years before. Out of the 22 cases, we performed surgery on non-affected eye or muscle in 12 cases. In the remaining 10 cases, surgery was performed on previously operated muscles, including 5 cases that revealed the site of previous surgery during surgery by us. The eye position became parallel in 8 cases and improved in 14 cases. All the 22 cases showed cosmetic satisfaction.

Conclusion: Postoperatively, eye position became parallel or improved in 22 adults who had past history of strabismus surgery. The previously operated muscle could not be initially identified by us in 5 cases.