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나팔꽃증후군에서 감각사시 교정 후 발생한 항상전증후군

Antielevation Syndrome caused by Sensory Strabismus Surgery in Morning Glory Syndrome

검안 및 콘택트렌즈학회지 2020년 19권 4호 p.110 ~ 113
채우정, 조순영,
소속 상세정보
채우정 ( Chae Woo-Jung ) - Dongguk University College of Medicine Department of Ophthalmology
조순영 ( Cho Soon-Young ) - Dongguk University College of Medicine Department of Ophthalmology

Abstract


Purpose: We report a case of antielevation syndrome caused by sensory strabismus surgery for the treatment of exotropia and hypertropia in morning glory syndrome.

Case summary: A 4-year-old girl visited our hospital due to outward deviation of her left eye since birth. She showed 60 prism diopters (PD) exotropia and 20 PD hypertropia of her left eye by the Krimsky test. During fundus examination, we found funnel-shaped excavation of the posterior fundus. She was diagnosed to have sensory exotropia and hypertropia associated with morning glory syndrome. The patient received lateral rectus muscle recession (9.0 mm), medial rectus muscle resection (7.0 mm) and inferior oblique anteriorization 1.0 mm posterior to the inferior rectus muscle lateral border on her left eye. One week after surgery, the patient showed orthotropia at near fixation and far fixation in the primary position, and 2 months after surgery, the patient showed 6 PD exotropia and 2 PD hypertropia at near fixation and 10 PD exotropia at far fixation of her left eye in the primary position. However, antielevation syndrome was noticed and attributed to the use of unilateral inferior oblique transposition for the correction of hypertropia.

Conclusions: The exptropia and hypertropia in morning glory syndrome was effectively treated with lateral rectus muscle recession, medial rectus muscle resection and inferior oblique muscle transposition. This case cautions meticulous care is needed to prevent antielevation syndrome when performing unilateral inferior oblique transposition.

키워드

Morning glory syndrome; Strabismus; Surgery

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