목적 : 사시 환아에서 안축장 크기와 기능적 적도부 위치분포를 알아보고 술 전 사시각을 기준으로 시행하는 기존 수술방법에 부가하여 각각의 안축장 차이를 고려한 보정된 수술 방법을 모색하고자 하였다. 대상과 방법 : 전신마취하에서 사시수술을 시행받은 12세 이하의 환아 중 안구의 기질적인 이상이 없는 총 50명 100안을 대상으로 안축장을 측정하고 기능적 적도부의 거리를 계산하였다. 결과 : 평균적으로 안축장은 22.01±0.97 mm로 측정되었고 각막 윤부로부터 내직근과 외직근의 기능적 적도부까지의 거리는 각각 11.35±0.67 mm와 18.48±0.94 mm, 이에 대한 직선거리는 각각 10.86±0.62 mm와 16.40±0.79 mm로 계산되었다. 결론 : 내사시 환아에서 사시각을 기준으로 양안 내직근 후전술을 시행할 때, 사시각이 40 프리즘디옵터(prism diopters, PD)인 경우는 기존의 내직근 후전 위치가 저자들이 계산한 내직근의 기능적 적도부의 위치와 거의 일치하였으므로, 사시각이 40 PD라면 기능적 적도부에 내직근을 후전하고, 사시각이 40 PD보다 작은 경우에는 기능적 적도부의 앞쪽에, 40 PD보다 큰 경우에는 기능적 적도부보다 뒤쪽으로, 개개인의 안축장 차이와 술 전 사시각을 동시에 고려하여 단계적으로 후전하는 새로운 술식을 제안한다.

Purpose: We are to know the distribution of the axial lengths and functional equators in strabismus patients and to establish surgical formula considering axial lengths in addition to the preoperative deviation angle. Methods: Included were 100 eyes of 50 strabismus children under 12 years old who do not have other organic disorders and received strabismus surgery under general anesthesia. We measured axial lengths and calculated functional equators. Results: Mean value of axial length was 22.01±0.97 mm. The distances from limbus to the functional equators of medial and lateral rectus muscles were 11.35±0.67 mm and 18.48±0.94 mm each and direct distance for that were 10.86±0.62 mm and 16.40±0.79 mm. Conclusions: By the conventional amount of both medial rectus muscle recession in esotropia patient, the recession for the preoperative deviation angle of 40 prism diopter locates medial rectus muscle at the functional equator. So taking both axial length and preoperative deviation angle into account, we proposed new surgical formula for esotropia as follows. For the preoperative deviation angle of 40 prism diopter, we are to recess both medial rectus muscles to the functional equator calculated by axial length and for the preoperative deviation angle smaller or larger than 40 prism diopter, recess to the site anterior or posterior to the functional equator proportionally.

Purpose: We are to know the distribution of the axial lengths and functional equators in strabismus patients and to establish surgical formula considering axial lengths in addition to the preoperative deviation angle. Methods: Included were 100 eyes of 50 strabismus children under 12 years old who do not have other organic disorders and received strabismus surgery under general anesthesia. We measured axial lengths and calculated functional equators. Results: Mean value of axial length was 22.01±0.97 mm. The distances from limbus to the functional equators of medial and lateral rectus muscles were 11.35±0.67 mm and 18.48±0.94 mm each and direct distance for that were 10.86±0.62 mm and 16.40±0.79 mm. Conclusions: By the conventional amount of both medial rectus muscle recession in esotropia patient, the recession for the preoperative deviation angle of 40 prism diopter locates medial rectus muscle at the functional equator. So taking both axial length and preoperative deviation angle into account, we proposed new surgical formula for esotropia as follows. For the preoperative deviation angle of 40 prism diopter, we are to recess both medial rectus muscles to the functional equator calculated by axial length and for the preoperative deviation angle smaller or larger than 40 prism diopter, recess to the site anterior or posterior to the functional equator proportionally.

Axial length, Equator, Strabismus