複視に対するプリズム適応の検討 Indications of prism prescription for diplopia
<b>Purpose</b><br>To clarify the reasons of dissatisfaction for prisms by means of comparing the cases who were successfully treated with prisms and the cases who were not.<br><b>Subjects and Methods</b><br>This is a retrospective chart review.<br>The patients older than 20 years, who visited Hamamatsu university school of medicine, department of Ophthalmology with a chief complaint of diplopia between January 2003 and May 2005 were studied. Within 144 patients, the patients with insufficient records of eye positions and the patients who were not followed were excluded. The remaining 86 cases were studied.<br>The patients were divided into two groups: 1) adaptation: who were satisfied with prisms, and 2) non-adaptation: who were not satisfied with prisms. Gender, age, diagnosis, vision, and ocular deviations were compared between the two groups.<br><b>Results</b><br>Twelve patients did not require prisms because of little trouble and they were excluded from the study. Thirty-three patients were adapted to the prisms. Seventeen patients did not satisfy prisms regardless they were prescribed prisms, and 24 patients underwent strabismus surgery. A total of 41 patients were classified to the non-adapted group.<br>There were no significant differences between the two groups in age, gender, the amount of horizontal deviation and the amount of torsional deviation. Only the vertical deviation was significantly larger in non-adapted group than in the adapted group (near: p<0.001, far: p<0.0001). Among the patients with superior oblique palsy, the amount of vertical deviation was larger and the patients were younger in the non-adapted group. These findings were not observed in the patients without superior oblique palsy, <br><b>Conclusions</b><br>Less than a half of patients satisfied with prisms. The patients' satisfaction was strongly influenced by the amount of vertical deviation. Young patients with superior oblique palsy were unlikely to satisfy with the prisms. It is difficult to speculate the patients who may satisfy with prisms or not. Therefore we need to try prisms on each patient.
- Japanese orthoptic journal
Japanese orthoptic journal 35, 93-97, 2006-08-31
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