메타분석을 통한 간헐외사시의 비수술처치 효과 = The Effects of Nonsurgical Treatment in Intermittent Exotropia by Meta-Analysis

다국어 초록 (Multilingual Abstract)

Purpose: To understand research trends in domestic and foreign primary studies related to the effect of nonsurgical treatment of intermittent exotropia by meta-analysis, and to suggest clinical and theoretical implications based on the direction and magnitude of the nonsurgical treatment effect for intermittent exotropia.
Methods: Of the thesis related to the effect of nonsurgical treatment of intermittent exotropia published in domestic and international journals and dissertations from 1990 to 2015, 15 papers selected from the inclusion and exclusion criteria were analyzed for meta-analysis. The effect size and variance of individual primary studies and overall effect size were calculated and then verified homogeneity. Also, the difference of effective size in different treatment methods by sub-group was verified. The treatment method, type of strabismus and age of treatment time were selected as variables to be considered for conducting the non-surgical treatment of intermittent exotropia, and the effect of each variable on treatment of intermittent exotropia were analyzed.
Results: The overall effect size of non-surgical treatment of intermittent exotropia was -0.715. The order of effect size of the treatment method was orthoptics; -1.753, mixed treatment; -1.747, correction of refractive error; -1.295, minus lens overcorrection; -0.500 and then occlusion therapy; -0.281. The order of effect size of strabismus types was divergent excess; -2.111, convergence insufficiency; -1.171, and then basic; -1.220. The order of effect size of age groups was 13∼19 yrs.; -2.029, 7∼13 yrs.; -1.057, under 4 yrs.; -0.751 and then 4∼7 yrs.; -0.379.
Conclusions: It is considered that the effect size in this study was analysed quantitatively the improving effect such as the decrease of deviation or the improvement of stereopsis and so on with the nonsurgical treatment in patients with intermittent exotropia, and the objective relevance of the nonsurgical treatment was suggested by these results.

국문 초록 (Abstract)

목적: 간헐외사시의 비수술처치 효과에 관한 국내외 개별연구들을 대상으로 메타분석을 이용하여 현재까지 연구 동향을 파악하고, 간헐외사시에 대한 비수술처치 효과의 방향과 크기를 바탕으로 임상적 및 이론적 의미를 제시하고자 하였다.
방법: 간헐외사시의 비수술처치 효과에 대한 논문들을 메타분석하기 위하여 1990년부터 2015년까지 발표된 국내외 학위논문과 학술지를 대상으로 포함 및 배제 기준을 적용하여 15편을 선정하였다. 개별연구들로부터 연구별 효과크기와 변량, 전체 효과크기를 산출하고 동질성을 검증한 후 처치변인별 하위요인의 효과크기 차이를 검증하였다. 비수술처치에서 고려할 항목으로 치료 방법, 사시 유형, 연령 수준 등을 선정하였으며, 각 항목이 간헐외사시의 치료에 미치는 효과를 구분하여 분석하였다.
결과: 간헐외사시의 치료를 위한 비수술처치 방법의 전체 효과크기는 -0.715이었다. 치료 방법의 효과크기는 시기능훈련; -1.753, 혼합치료; -1.747, 굴절이상교정; -1.295, 마이너스렌즈 과교정; -0.500, 가림치료; -0.281 순이었다. 사시 유형별 효과크기는 개산과다; -2.111, 폭주부족; -1.171, 기본형; -1.220 순이었다. 연령별 효과크기는 13~19세; -2.029, 7~13세; -1.057, 4세 미만; -0.751, 및 4~7세; -0.379 순이었다.
결론: 본 연구에서 제시된 효과크기들은 간헐외사시의 비수술처치에 의한 사시각 감소나 입체시 향상 등의 개선효과를 정량적으로 분석한 것이며, 이로부터 비수술처치의 객관적 타당성이 제시된 것으로 생각된다.

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