Korean J Ophthalmol.  2008 Sep;22(3):178-182. 10.3341/kjo.2008.22.3.178.

Consecutive Esodeviation After Exotropia Surgery in Patients Older than 15 Years: Comparison with Younger Patients

• Park HJ
• Kong SM
• Baek SH

• KMID: 1070754
• DOI: http://doi.org/10.3341/kjo.2008.22.3.178

Abstract

PURPOSE: The purpose of this study was to investigate the clinical course of esodeviation after exotropia surgery in older patients (older than 15 years) and to compare it with that in younger patients (15 years or younger). METHODS: The medical records of all surgeries for exodeviation from December 2004 to February 2007 were reviewed and 82 patients were found with consecutive esodeviation. The patients were divided into two groups according to their age: Group A (patients older than 15 years) and Group B (patients age 15 or younger). The clinical course of esodeviation in Group A was compared to that in Group B by means of survival analysis. RESULTS: The median survival times of the esodeviation were 2.0+/-0.1 months in Group A and 1.0+/-0.1 months in Group B (p=0.40). The prevalence of consecutive esotropia at six months was 0% in Group A and 6.1% in Group B (p=0.32). The myopic refractive error, worse sensory condition, and a larger preoperative exodeviation in Group A did not affect the clinical course of the two groups differently. CONCLUSIONS: The postoperative esodeviation of patients older than 15 years after exotropia surgery tended to persist longer during the early postoperative period than that of patients 15 years or younger, however, the difference did not persist at postoperative six months.

Keyword

Consecutive esotropia; Postoperative esodeviation; Exotropia surgery; Survival analysis

MeSH Terms

Adult
Age Factors
Child
Esotropia/*etiology/physiopathology
Exotropia/*surgery
Female
Humans
Kaplan-Meiers Estimate
Male
Oculomotor Muscles/*surgery
*Postoperative Complications
Vision, Binocular/physiology
Visual Acuity/physiology

Figure

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  Fig. 1 Kaplan-Meier survival curves of Group A (older age group with esodeviation after surgery for exotropia; green line) and Group B (younger age group with esodeviation after surgery for exotropia blue line). These survival curves indicated that the estimated median survival times were 2.0±0.1 months in group A and 1.0±0.1 months in group B. Their difference was not statistically significant even though the median survival time seemed larger in Group A than in Group B (p=0.40, Log Rank test).

Reference

1. Scott WE, Keech R, Mash AJ. The postoperative results and stability of exodeviation. Arch Ophthalmol. 1981. 99:1814–1818.

2. Raab EL, Parks MM. Recession of the lateral recti. Early and late postoperative alignments. Arch Ophthalmol. 1969. 82:203–208.

3. Oh JY, Hwang JM. Survival analysis of 365 patients with exotropia after surgery. Eye. 2006. 20:1268–1272.

4. Von noorden GK. Binocular vision and ocular motility. 1996. Vol. 1:5th ed. St. Louis, Mo: CV Mosby;352–355.

5. Pratt-Johnson JA, Barlow JM, Tillson G. Early surgery in intermittent exotropia. Am J Ophthalmol. 1977. 84:689–694.

6. Edelman PM, Broan MH, Murphree AL, Wright KW. Consecutive esodeviation: the what? Am Orthoptic J. 1988. 38:111–116.

7. Son AN, Park SC, Lee WR. Clinical study of consecutive esotropia. J Korean Ophthalmol Soc. 1990. 31:1328–1334.

8. Hahm IR, Yoon SW, Baek SH, Kong SM. The clinical course of recurrent exotropia after reoperation for exodeviation. Korean J Ophthalmol. 2005. 19:140–144.

9. Abraham SM, Richard SM. The surgical Management of Intermittent exotropia in Adults. Ophthalmology. 1983. 90:1166–1171.

10. Parks MM. Duane TD, editor. Comitant Exodeviations. Clinical Ophthalmology. 1990. vol. 1. Philadelphia: Harper Row and Company;chap. 13.

11. Fletcher MC, Silverman SJ. A summary of 1.110 consecutive cases. Am J Ophthalmol. 1966. 61:86–94.

12. Clarke WN, Noel LP. Surgical result in intermittent exotropia. Can J Ophthalmol. 1981. 16:66–69.

13. Lee S, Lee YC. Relationship between motor alignment at postoperative 1 day and year 1 after after symmetric and asymmetric surgery in intermittent exotropia. Jpn J Ophthalmol. 2001. 45:167–171.

14. Dunlap EA. Manley DR, editor. Overcorrections in exotropia surgery. Symposium on horizontal ocular deviations. 1971. 1. St. Louis: The C.V. Mosby CO.;183.

15. Keech RV, Stewart SA. The surgical overcorrection of intermittent exotropia. J Pediatr Ophthalmol Strabismus. 1990. 27:218–220.

16. Park HS, Kim JB, Seo MS, Park YG. A study on the consecutive esotropia after intermittent exotropia surgery. J Korean Ophthlmol Soc. 1994. 35:1327–1334.