기본형 간헐외사시수술 후 재발된 간헐외사시의 형태 변화

황성하,백혜정 대한안과학회 2018 대한안과학회지 Vol.59 No.8

Purpose: To report the surgical outcomes and changes in types of recurrent exotropia after surgical correction of basic type intermittent exotropia. Methods: We retrospectively analyzed the medical records of 91 patients who underwent reoperations for recurrent exotropia after primary surgical correction, and who visited our hospital for a period of at least one year after the reoperation. When distant deviation was >30 prism diopters (PD), we defined convergence insufficiency type (CI type) if the difference of the deviation angle was >10 PD and basic type exotropia if the difference was <10 PD. When distant deviation was <30 PD, we defined basic type exotropia if the difference of the deviation angle between at distant and near was <33% of the distant deviation angle, and CI type exotropia if the difference was >33% of the distant deviation angle. Results: The types of recurrent exotropia were similar to those of the preoperative condition in 68 patients (74.7%), and newly emergent CI type was observed in 23 patients (25.3%). With regard to the incidence of CI type, bilateral lateral rectus recession was more common than unilateral lateral rectus recession after primary surgery and medial rectus resection and unilateral lateral rectus recession, but the difference was not significant (p = 0.615). Recurrent CI type exotropia was observed 6 months after primary surgery (p < 0.001), but there was no significant difference in the timing of the reoperation between the two groups (p > 0.05). There was no significant difference in the success of reoperations between the two groups (p > 0.05). Conclusions: The types of recurrent exotropia after surgical correction of primary basic type intermittent exotropia differed from those of preoperative exotropia, which was not related to various factors before surgery. Recurrent exotropia was successfully treated by appropriately selected reoperations, regardless of the type of exotropia. 목적: 술 전 기본형 간헐외사시 환자 중 수술 후 외사시가 재발하여 이차로 재수술을 시행하여야 했던 경우를 대상으로 하여 수술 전후 간헐외사시의 형태 변화가 있는지를 알아보고, 변한 형태에 따라 재수술 성공률을 알아보고자 하였다. 대상과 방법: 기본형 간헐외사시 진단하에 사시수술을 시행받은 환자 중, 외사시가 재발하여 재수술을 시행하고 술 후 1년 이상 경과관찰이 가능했던 91명의 의무기록지를 후향 분석하였다. 원거리 사시각이 30프리즘디옵터 이상일 때, 근거리에서 원거리보다 10프리즘디옵터 이상 큰 경우 눈모음부족외사시 군으로 정의하였고, 그 미만은 기본외사시 군으로 정의하였다. 원거리사시각이 30프리즘디옵터 미만일 때는 원거리와 근거리 사시각의 차이가 원거리 사시각 기준 1/3 이상일 때 눈모음부족외사시 군으로 정의하였고, 그 미만은 기본외사시 군으로 정의하였다. 결과: 사시각검사상 재발 외사시의 형태는 술 전과 동일한 기본형 68명(74.7%), 눈모음부족형 23명(25.3%)으로 눈모음부족외사시가 발생하였다. 1차 수술로 양안 외직근후전술을 시행한 경우 15명(30%)에서 눈모음부족외사시가 발생하여, 단안 외직근후전술 및 내직근절제술을 시행한 경우 6명(20%), 단안 외직근후전술을 시행한 경우 2명(18.2%)에 비해 더 흔하게 발생하였으나 차이는 유의하지 않았다(p=0.615). 재발 눈모음부족외사시는 재발 기본형 외사시 군에 비해 특히 1차 수술 6개월 이후에 발생하는 양상을 보였으나(p<0.001) 재수술 시행 시기는 유의한 차이는 없었다(p>0.05). 재수술 후 1년 이상 추적관찰상 두 군의 수술 성공률은 유의한 차이는없었다(p>0.05). 결론: 기본형 간헐외사시 수술 후 재발한 외사시는 술 전과 비교해 기본형 외에 눈모음부족외사시가 새로이 발생하였으나 이는 일차수술 방법이나 술 전 여러 요소들과는 무관한 것으로 생각되었다. 또한 재발된 기본외사시와 눈모음부족외사시 모두 적절히 선택된재수술로 성공적으로 치료할 수 있었다.

간헐외사시 재수술 후 다시 재발한 환자의 임상양상

김태진(Tae Jin Kim),김대현(Hyun Kim) 대한안과학회 2017 대한안과학회지 Vol.58 No.11

적: 간헐외사시 재수술 후 다시 재발된 간헐외사시 환자의 임상양상을 분석하고 위험인자 및 예후 등을 알아보았다. 대상과 방법: 간헐외사시 첫 수술 후 외사시가 재발하여 재수술을 시행 받은 39명의 환자에서 경과관찰 중 외사시가 다시 재발한 환자의 발생빈도, 위험인자, 치료방법, 예후 등을 분석하였다. 결과: 전체 환자 39명에서 24명(61.5%)이 간헐외사시가 다시 재발하였고 15명은 간헐외사시가 다시 재발하지 않았다. 재수술 전 나이, 사시각, 굴절력, 부등시, 바깥쪽불일치, 수직편위 유무는 간헐외사시가 다시 재발하는 데 영향이 없었다. 그러나 첫 수술로 두 눈 외직 근후전술을 시행한 후 재수술로 두 눈 내직근절제술이나 한 눈 내직근절제술을 시행한 경우가 첫 수술로 한 눈 외직근후전술과 내직 근절제술을 시행한 후 재수술로 반대쪽 눈 외직근후전술과 내직근절제술을 시행한 경우에 비해 간헐외사시가 다시 재발하는 경향을 보였다(p<0.05). 또한 술 후 1일째 10프리즘디옵터(prism diopter, PD) 미만의 내편위 또는 정위 및 외편위를 보이는 경우가 10프리즘 디옵터 이상의 내편위를 보이는 경우에 비해 다시 재발하는 경향을 보였다(p<0.05). 결론: 간헐외사시 재수술 후 재발에 영향을 미치는 인자는 수술방법 및 수술 후 과교정도 등이 수술적인 요인일 것으로 생각된다. Purpose: We reviewed the clinical features of intermittent exotropic patients who experienced recurrence after reoperation for intermittent exotropia, and identified the risk factors and prognoses. Methods: The incidences, risk factors, treatment modalities, and prognoses of patients with recurrent exotropia were analyzed in 39 patients who underwent reoperation due to a relapse of exotropia after the first intermittent exotropia. Results: Among 39 patients, 24 (61.5%) had recurrent intermittent exotropia and 15 patients had no recurrence with intermittent exotropia. There was no difference in the recurrence of intermittent exotropia with age, deviation, refraction, anisometropia, outward discrepancy, and the vertical deviation before the reoperation. However, when the first operation was performed with bilateral lateral rectus recession and the reoperation was performed with bilateral medial rectus resection or unilateral medial rectus resection, intermittent exotropia tended to recur more than when the first operation was performed with one eye with lateral rectus recession and medial rectus resection, followed by reoperation with the other lateral rectus recession and medial rectus resection (p < 0.05). In addition, an esodeviation <10 prism diopters, orthophoria, or exotropia on the first postoperative day showed a tendency to relapse more than an esodeviation >10 prism diopters (p < 0.05). Conclusions: The factors affecting recurrence after intermittent exotropia surgery involve surgical factors such as the surgical method and the postoperative overcorrection. J Korean Ophthalmol Soc 2017;58(11):1248-1253

외사시를 보이는 듀안안구후퇴증후군 I형 1예

장정현(Jung Hyun Jang),박정민(Jung Min Park),이수정(Soo Jung Lee) 대한검안학회 2012 Annals of optometry and contact lens Vol.11 No.1

목적: 외사시를 보이는 듀안안구후퇴증후군 I형 1예를 경험하였기에 이를 보고하고자 한다. 대상과 방법: 8세 여아가 우측 주시 시 좌안의 함몰 및 눈꺼풀 틈새의 축소와 과도한 내상전, 내하전, 좌안 외전장애가 관찰되었다. 제1안위에서 원거리 주시 시 15프리즘디옵터(PD), 근거리 주시 시 25PD의 좌안 외사시가 있었으며, 우측 주시 시 35 PD의 외사시, 좌측 주시 시 18 PD의 내사시가 있었다. 외사시를 보이는 듀안안구후퇴증후군 I형으로 진단하였고, 외전장애의 치료를 위해 좌안에 Hummelsheim 수술을 하였다. 결과: 외전장애는 호전되었으나, 외사시가 증가되어 우안 외직근후전술을 시행하였다. 술 후 외측불일치는 호전되었으나, 남아있는 외사시와 내전 시 과도한 상하전을 치료하기 위해 좌안 외직근후전술과 후봉합술을 시행하였다. 최종 수술 후 원거리 주시 시 정위, 근거리 주시 시 10 PD의 외사시를 보였으며, 외측 불일치와 내전 시 과도한 상전과 하전도 각각 +2, 0으로 호전되었으나 좌안의 외전장애는 -3으로 다시 증가하였다. 결론: 듀안안구후퇴증후군 I형 중 외사시를 보이는 경우 외전장애보다는 외사시의 치료에 중점을 두어야 할 것으로 생각한다. Purpose: To present a case of Duane’s retraction syndrome type I showing an exotropia. Methods: A 8-year-old girl showed global retraction, palpebral fissure narrowing, upshoot (+4), downshoot (+3) on adduction, and limitation of abduction (-4) in the left eye. She had an exotropia of 15 PD at distance, 25 PD at near in the primary position. She was diagnosed with Duane’s retraction syndrome type I of the left eye showing an exotropia. Because her mother had strong desire for correction of limitation of abduction as well as an exotropia, the Hummelsheim surgery was performed in the left eye to correct limitation of abduction. Results: She achieved improvement in abduction (-2) but exotropia was aggravated to 20 PD at distance, and 30 PD at near. Lateral rectus recession (10 mm) was done in the right eye for correction of exotropia. After 2nd surgery, lateral incomitance was improved but she had still exotropia of 10 PD at distance, 20 PD at near. Lateral rectus recession (7 mm) and posterior fixation of the left eye were performed to correct an exotropia, upshoot, and downshoot on adduction. After final surgery, she showed an orthotropia at distance, exotropia of 10 PD at near, and improvement in lateral incomitance, upshoot (+2) and downshoot (0). However, limitation of abduction was aggravated to -3 in the left eye. Conclusions: We recommend a focus of treatment in a case of Duane’s retraction syndrome type I showing an exotropia should not be limitation of abduction but an exotropia.

간헐기를 거친 항상성 외사시의 임상특징

서영우,차덕선,조윤애,김승현.Young-Woo Suh. MD. PhD. Deoksun Cha. MD. Yoonae A. Cho. MD. PhD. Seung-Hyun Kim. MD. PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.4

Purpose: To investigate clinical characteristics of constant exotropia patients with a previous history of intermittent exotropia. Methods: Constant exotropia patients (CXT) with a previous history of intermittency, and intermittent exotropia patients (X [T]) who had undergone surgery for exotropia were included in the present study. Patching therapy of the fixating eye was performed for all patients. Surgical results, the effect of patching, lateral incomitancy, and suppression were retrospectively reviewed and compared between the 2 groups. Results: The number of CXT was 51 and X (T) was 84. The angles of deviation at the initial visit and at surgery were significantly larger in CXT. After 3 months of patching therapy, there was no difference between the 2 groups in the reduction of distant angle of deviation. However, the reduction of near angle of deviation was 0.29 ± 5.44 in CXT and 4.42 ± 6.26 Δ in X (T), which was significantly different (p = 0.04). Lateral incomitancy was observed in 7.8% of CXT and 34.5% of X (T) (p < 0.001). The angles of deviation at the final visit and surgical success rate were not different between the groups. Preoperative suppression at distant was found in 100% of CXT and 88.7% of X (T), and postoperative suppression was in 17.6% and 18.3%, respectively. Conclusions: The surgical success rate and postoperative suppression were not different between constant exotropia and intermittent exotropia. However, the frequency of lateral incomitancy and the response to the patching therapy was lower in constant exotropia. J Korean Ophthalmol Soc 2011;52(4):462-465

감각외사시와 일치외사시의 장기 수술 결과 비교

신정혜,김성준,정재호 대한안과학회 2023 대한안과학회지 Vol.64 No.11

목적: 감각외사시 환자와 일치외사시 환자의 장기적인 수술 성적을 비교하고, 감각외사시 수술 예후와 관련된 인자들에 대해 알아보고자 했다. 대상과 방법: 감각외사시는 편위안의 최대교정시력이 0.2 미만인 경우로 정의하였다. 감각외사시 수술 후 2년 이상 경과 관찰이 가능하였던 28명의 수술 성공률을 분석하기 위해 주시 방향에 따라 사시각의 차이가 없는 일치외사시로 수술을 받은 환자 중 감각외사시수술 환자와 성별, 연령, 수술 전 최대 원거리 및 근거리사시각을 매칭한 28명을 대조군으로 하여 의무기록을 후향적으로 분석하였다. 또한, 감각외사시 환자군 장기 수술 결과를 분석하기 위해 수술 3년 후 결과를 추가 조사하였다. 수술 성공은 최종 내원 시 원거리사시각이 정위에서 10프리즘디옵터(prism diopters, PD) 이내인 경우로 정하였다. 감각외사시 수술 후 재발과 관련된 위험 인자의 분석을위해 Cox 비례위험모형을 사용하였다. 결과: 수술 후 평균 추적 관찰 기간은 감각외사시군에서 91.7 ± 45.8개월, 대조군에서 42.6 ± 27.7개월이었다. Kaplan-Meier 생존분석에서 감각외사시군의 술 후 2년째 누적 수술 성공률은 74.5%였고 대조군은 74.4%로, 두 군 간 유의한 차이는 없었다(p=0.988). 감각외사시군에서 원근거리사시각 차이가 클수록 수술 후 재발 위험이 증가하는 것으로 나타났다(p=0.091). 결론: 감각외사시 환자와 일치외사시 환자의 수술 성공률은 유의한 차이를 보이지 않았으며 감각외사시 환자에서 원근거리사시각차이가 클수록 수술 후 재발 위험이 증가하였다. Purpose: To compare the long-term surgical outcomes of patients with sensory and concomitant exotropia and to define the factors associated with successful surgical outcomes in those with sensory exotropia. Methods: The medical records of patients with sensory exotropia who underwent operations and were followed-up for at least 2 years were retrospectively reviewed. We enrolled patients exhibiting only best-corrected visual acuities ≤ 20/100 of the operated eyes. Surgical success was defined as a final distance deviation < 10 prism diopters (PD) with the eye in the primary position. Twenty-eight patients operated upon to treat sensory exotropia and 28 who underwent operations to treat concomitant exotropia who did not differ in terms of the gaze deviation angle were matched in terms of age, sex, and the preoperative distance and near distributions; their surgical outcomes were compared. Factors affecting such outcomes were identified using a multivariate Cox’s proportional hazards model. Results: The mean follow-up times were 91.7 ± 45.8 months in the sensory and 42.6 ± 27.7 months in the concomitant exotropia groups. The cumulative probabilities of surgical success 2 years after surgery were 74.5% in the sensory and 74.4% in the intermittent exotropia groups, thus not significantly different (p = 0.988). The Cox’s proportional hazard model showed that a greater difference between the preoperative distant and near deviations was associated with recurrence (p = 0.091). Conclusions: The long-term surgical outcomes of patients with sensory and concomitant exotropia were comparable. A high-level near-distance disparity increased the risk of recurrence.

간헐외사시 소아와 정상 소아의 읽기 속도 비교

김지수,최미영 대한안과학회 2020 대한안과학회지 Vol.61 No.7

Purpose: We investigated the reading speeds of elementary school-aged children with or without intermittent exotropia. Methods: Children between the ages of 7 and 12 years with intermittent exotropia without amblyopia (n = 37) and normal-sighted children (n = 37) were included. Near-stereopsis and fusion were evaluated. Reading speeds were calculated using a Korean reading speed application, twice: once for reading the sentence silently (reading only) and a second time for reading the sentence aloud (reading & speaking). Reading speed was recorded in words per minute (WPM) and letters per minute (LPM) according to the size of the letters. The factors related to reading speed were analyzed, and the reading speeds of the two groups were compared. Results: The rate of fusion at far and near extremes was lower in the intermittent exotropia group than in the control group (p = 0.028). There was a significant correlation between age and reading only speed and reading & speaking speed for both groups (p = 0.006, p = 0.004). Both WPM and LPM reading speeds of the reading only intermittent exotropia group were slower than those of the control group (p = 0.048, p = 0.050); however, the differences between groups became more pronounced after correction for the age distribution (p = 0.029, p = 0.035). LPM reading speed for middle-sized letters was significantly slower in the intermittent exotropia group than in the control group (p = 0.046). There was no statistical difference between the two groups regarding the reading speed or reading & speaking speed. Conclusions: the reading only and reading & speaking speeds increased with the age of the student, regardless of whether the student had intermittent exotropia. The reading only speed was considerably slower in the intermittent exotropia group. Thus, measures should be taken to monitor the reading development of younger school-aged children with intermittent exotropia carefully to allow for early intervention should issues arise. 목적: 초등학생에서 읽기 속도가 간헐외사시 유무에 따라 차이가 있는지 알아보고자 한다. 대상과 방법: 약시가 없는 7-12세의 간헐외사시 37명과 대조군 37명에서 근거리 입체시, 워트4등검사, 한국어 읽기 속도 측정 애플리케이션을 이용한 묵독과 음독의 읽기 속도를 측정하였다. 읽기 속도는 분당 단어 수(words per minute, WPM)와 분당 음절 수(letters per minute, LPM)로 나타냈으며, 글자 크기에 따라 분류하여 검사하였다. 각 군 내에서 읽기 속도에 영향을 주는 인자를 분석하였으며, 두 군 사이의 읽기 속도를 비교하였다. 결과: 두 군 사이에 입체시는 통계학적으로 차이는 없었으나, 근거리와 원거리에서 모두 융합이 가능한 비율이 간헐외사시군에서 대조군보다 낮았다(78.4%:97.3%, p=0.028). 각 군에서 나이의 증가에 따라 묵독과 음독 속도 모두 유의하게 빨라졌으며(p=0.006, p=0.004), 읽기 속도에 영향을 주는 다른 인자는 없었다. 간헐외사시군에서 전체 묵독 속도 평균은 WPM, LPM 모두 대조군보다 더 느렸다(p=0.048, p=0.050). 나이를 보정한 후의 WPM과 LPM은 간헐외사시군에서 통계학적으로 의미 있게 더 느렸으며(p=0.029, p=0.035), 중간 글자에서의 LPM에서 유의한 차이를 보였다(p=0.046). 두 군 사이에 음독 속도는 통계학적으로 차이 없었다. 결론: 초등학생에서 간헐외사시의 유무에 상관없이, 나이가 증가함에 따라 묵독 및 음독의 읽기 속도는 빨라졌다. 간헐외사시군에서 대조군에 비하여 묵독 속도가 느린 것으로 나타났으므로, 간헐외사시로 진단받은 초등학생에서 묵독 속도에 대한 관심이 필요할 것으로 생각한다.

하사근기능항진이 없는 V형 외사시와 기본형 일치외사시의 수술 결과 비교

배신우,최미영,Sin Woo Bae,Mi Young Choi 대한안과학회 2013 대한안과학회지 Vol.54 No.2

Purpose: To compare the surgical outcome between V-pattern intermittent exotropia without inferior oblique overaction and comitant intermittent exotropia. Methods: The authors of the present study investigated 15 patients (V-pattern group) who had standard horizontal surgery with half-tendon width vertical transposition and 36 patients (Comitant group) with unilateral rectus muscle recession/ resection. Preoperative visual acuity, presence of amblyopia, abnormal head posture, stereoacuity, amount of exotropia, and duration of postoperative diplopia were recorded. Surgical success was defined as final alignment of orthophoria or less than 10 PD orthophoria. Results: The frequency of good stereoacuity with 80 sec of stereoacuity or more was higher in the V-pattern group (73.3%) than in the Comitant group (33.3%) (Fisher’s exact test, p = 0.01). One case of V-pattern showed consecutive esotropia for 1 year postoperatively. Exotropia recurred in 2 patients in the V-pattern group (13.3%), and in 4 patients in the Comitant group (11.1%) 1 year postoperatively. Surgical success rates were statistically significant higher in the V-pattern group (86.7%) as compared to the Comitant group (58.3%) on final follow-up (Fisher’s exact test, p = 0.04). Conclusions: V-pattern exotropia patients without inferior oblique overaction who had standard horizontal surgery with half-tendon width vertical transposition showed a lower recurrence rate of exotropia than patients with comitant intermittent exotropia. J Korean Ophthalmol

주기외사시 치험 1예

최한뉘,하석규,김승현 대한안과학회 2017 대한안과학회지 Vol.58 No.8

목적: 주기외사시로 진단 받은 소아 환아를 치료한 경험을 보고하고자 한다. 증례요약: 30개월 여자 환아가 간헐적으로 눈이 밖으로 돌아나간다며 본원 사시클리닉에 내원하였다. 1년간 경과관찰 하였으며, 정위를 보일 때도 두 차례 있었고 25프리즘디옵터 외편위를 보이기도 하였다. 수술을 계획하였고, 입원하여 사시각 검사를 시행하였다. 환아는 다시 정위를 보였고, 보호자에게 사시노트를 작성해 오도록 한 후 입원을 취소하였다. 사시노트의 분석 및 교대가림검사의 결과를 토대로, 환아를 72시간 주기의 주기외사시로 진단할 수 있었다. 이에, 좌안외직근후전술 8 mm를 시행하였다. 술 후 2년간 경과관찰 중이며, 저교정이나 재발을 보이지 않고 안정적인 경과를 보였다. Purpose: To report a case of cyclic exotropia in a pediatric patient. Case summary: There was a pediatric exotropia patient with large variation of prism diopter on alternate cover test at each visits. Not large enough for going through the surgery, she was recommended for the regular check-ups. Sometimes, she was orthophoria and some other times, distinct exotropia. After a few times of follow up, she showed 25-prism diopter exotropia on alternate cover test. The surgery was scheduled and she was admitted after 2 weeks. At the preoperative evaluation, she was orthophoria. She was discharged without having the surgery. To evaluate daily eyeball deviation status, the parents were asked to write a daily note on patient’s eye condition. For 3-months, daily strabismus note was thoroughly reviewed and alternate cover test was performed monthly. Patch test was performed twice, and results were 10 and 12 prism diopter exotropia, each. Analyzing the note, a cycle of being the orthophoria and exotropia was noted. With the cycle of 72-hours, she was diagnosed with cyclic exotropia and the surgery was re-scheduled. Ulnilateral lateral rectus recession was performed. Without undercorrection or recurrence, she has been stayed stable over two years of follow up period.

고질적인 외사시 환자에서 안구 뒤눈물능선골막 고정술

설보람,곽상인,김성준,Bo Ram Seol,Sang In Khwarg,Seong-Joon Kim 대한안과학회 2014 대한안과학회지 Vol.55 No.3

Purpose: To report the results obtained after fixation of the eyeball to the periosteum over the posterior lacrimal crest in 5 cases of inveterate exotropia. Methods: From September 2011 to January 2013, 5 patients with inveterate exotropia and a history of surgery for exotropia underwent fixation of the eyeball to the periosteum over the posterior lacrimal crest. Results: The mean preoperative exotropia of 35 ± 10.61 PD changed to esotropia of 5.8 ± 17.28 PD at the one week postoperative visit and exotropia of 13.2 ± 11.34 PD at the final postoperative visit (mean, 6.05 months after surgery). At the final postoperative visit, 2 patients who had ocular adhesion due to trauma showed 25 PD exotropia. None of the patients showed injuries to the lacrimal system, but 2 patients showed conjunctival granuloma. Conclusions: Fixation of the eyeball to the periosteum over the posterior lacrimal crest is an effective approach for the management of inveterate exotropia, except in cases of exotropia combined with ocular adhesion. J Korean Ophthalmol Soc 2014;55(3):408-415

항상 유아외사시와 간헐 유아외사시 환자에서 감각 및 운동 기능의 비교

황성수(),이수정() 대한안과학회 2016 대한안과학회지 Vol.57 No.11

목적: 항상과 간헐 원발 유아외사시 환자들의 임상양상을 파악함과 동시에 감각 및 운동기능에 차이가 있는지를 알아보고자 하였다. 대상과 방법: 2010년 3월부터 2015년 11월까지 원발 유아외사시로 진단 받은 환자 58명을 초진 시 사시 발현 빈도에 따라 항상(21명) 과 간헐(37명)로 나누어 두 군에서의 성별, 사시 가족력, 진단 나이, 구면렌즈대응치, 약시유무를 조사하였으며 사시 및 안구운동검사, 입체시 검사를 시행하여 비교하였다. 결과: 항상 유아외사시는 간헐 유아외사시에 비해 여아에서 더 흔하고(p=0.027), 우안에서 좀 더 근시 구면렌즈대응치(-0.99D)를 보였으나(p=0.023) 그 외 사시가족력 유무, 진단나이, 약시, 잠복 눈떨림과 입체시는 두 군 사이에 유의한 차이를 보이지는 않았다. 사시각의 크기도 근거리 주시시 및 원거리 주시시 모두 두 군의 차이가 없었고(p=0.598, p=0.518) 해리수직사시는 항상에서 2명, 간헐에 서 3명, 하사근기능항진은 항상에서 8명, 간헐에서 16명에서 동반되었으며 일치수직사시는 항상에서 1명, 간헐에서 3명에서 동반되었고 모두 유의한 차이를 보이지는 않았다. 결론: 원발 유아외사시 환자에서 외편위가 간헐적이라도 항상 유아외사시와 비슷한 임상양상을 보이므로 간헐 유아외사시 환자들도 항상 유아외사시 환자에서처럼 주의 깊은 관찰이 필요할 것으로 생각된다. <대한안과학회지 2016;57(11):1765-1769> Purpose: The aim of this study was to compare sensory and motor functions in patients with constant and intermittent primary infantile exotropia. Methods: From March 2010 to November 2015, 58 patients with primary infantile exotropia were divided into a constant group (21 patients) and an intermittent group (37 patients) according to frequency of exodeviation at the first visit. Sex, family history of strabismus, age at diagnosis, spherical equivalent, and presence of amblyopia were compared. Angle of deviation, ocular motor function, and stereopsis were measured. Results: Females were more prevalent (p = 0.027) and the spherical equivalent of the right eye was more myopic (-0.99 D) (p = 0.023) in the constant infantile exotropia group. However, there was no significant difference in family history of strabismus, age at diagnosis, amblyopia, latent nystagmus, or stereopsis between the two groups. There were no significant differences between the two groups in angle of deviation at near or distance (p = 0.598, p = 0.518). Dissociated vertical deviation was accompanied in 2 patients in the constant group and 3 in the intermittent group. Inferior oblique overaction was accompanied in 8 patients in the constant group and 16 in the intermittent group, while vertical deviation was accompanied in 1 patient in the constant group and 3 in the intermittent group. However, there were no significant differences between the groups for any of these findings. Conclusions: Constancy of exodeviation is insufficient to diagnose primary infantile exotropia. Compared to those in whom exodeviation was intermittent, the patients with constant infantile exotropia showed similar clinical features. Therefore, close observation is recommended in patients with intermittent and constant infantile exotropia. J Korean Ophthalmol Soc 2016;57(11):1765-1769