Korean J Ophthalmol.  2008 Mar;22(1):32-36. 10.3341/kjo.2008.22.1.32.

Results of Re-operation on the Deviated Eye in Patients with Sensory Heterotropia

• Kim MJ
• Khwarg SI
• Kim SJ
• Chang BL

• KMID: 1107488
• DOI: http://doi.org/10.3341/kjo.2008.22.1.32

Abstract

PURPOSE: To evaluate the result of re-operation on the deviated eye of recurred, consecutive or undercorrected sensory strabismus after surgery. METHODS: The medical records of 11 patients who had received second strabismus operation on the deviated eye due to recurred, consecutive or undercorrected sensory strabismus were studied retrospectively. RESULTS: Among the 11 patients, five patients were operated for recurred exotropia after surgery of sensory exotropia (group 1), two for consecutive exotropia after surgery of sensory esotropia (group 2), and four for undercorrected esotropia after surgery of sensory esotropia (group 3). Re-operation was performed 19.2+/-12.6 years after the first operation and the mean preoperative deviation before re-operation was 30.0+/-8.66 prism diopters (PD), 32.5+/-10.6PD, and 32.5+/-8.66PD, respectively. In all cases, a small amount of recession or resection compared with the usual surgical dosage was applied in re-operation on the deviated eye. The mean follow-up period after re-operation was 12.3+/-14.2 (1-48 months). Among the 11 patients, postoperative deviations less than 10PD were achieved postoperatively in 8 (72.7%) at 1 month and of the 8 patients with follow-up data beyond 6 months, 5 (62.5%) showed orthotropia within 10PD at 6 months or later. CONCLUSIONS: The surgical result of re-operation on the deviated eye of recurred, consecutive or undercorrected sensory strabismus after the first surgery was satisfactory in spite of the reduced amount of surgical correction compared with the surgical dosage recommended for the non-operated eye.

Keyword

Recurred sensory strabismus; Re-operation; Sensory strabismus; Strabismus surgery

MeSH Terms

Adolescent
Adult
Child
Child, Preschool
Female
Humans
Male
Oculomotor Muscles/*surgery
Ophthalmologic Surgical Procedures
Recurrence
Reoperation
Strabismus/*surgery
Time Factors
Treatment Outcome

Reference

1. von Noorden GK, Campos EC. Binocular vision and ocular motility. 2002. 6 th ed. St. Louis: CV Mosby;345–347.

2. Edelman PM, Brown MH. The stability of surgical results in patients with deep amblyopia. Am Orthopt J. 1977. 27:103–106.

3. Rosenbaum AL, Santiago AP. Clinical Strabismus Management. 1999. Philadelphia: W.B. Saunders Company;193–199.

4. Wright KW, Spiegel PH. Pediatric ophthalmology and strabismus. 2003. 2nd ed. New York: Springer;221.

5. Owens PL, Strominger MB, Rubin PA, et al. Large angle exotropia corrected by intraoperative botulinum toxin A and monocular recession resection surgery. J AAPOS. 1998. 2:144–146.

6. Raab EL. Unilateral four muscle surgery for large angle exotropia. Ophthalmology. 1979. 86:1441–1450.

7. Foundation of the American Academy of Ophthalmology. Basis and clinical science course. 2006. San Francisco: American Academy of Ophthalmology;179–181.

8. Lawson JM, Kousoulides L, Lee JP. Long term results of botulinum toxin in consecutive and secondary exotropia: outcome in patients initially treated with botulinum toxin. J AAPOS. 1998. 2:195–200.

9. Scott WE, Kutschke PJ, Lee WR. 20th annual Frank Costenbader Lecture adult strabismus. J Pediatr Ophthalmol Strabismus. 1995. 32:348–352.

10. Yazdian Z, Ghiassi G. Re recession of the lateral rectus muscles in patients with recurrent exotropia. J AAPOS. 2006. 10:164–167.

11. Langmann A, Lindner S, Koch M, et al. Dose-effect relation in revision surgery for consecutive strabismus divergens in adults. Ophthalmologe. 2005. 102:869–872.

12. Spierer A, Ben Simon GJ. Unilateral and bilateral lateral rectus recession in exotropia. Ophthalmic Surg Lasers Imaging. 2005. 36:114–117.

13. Morad Y, Kraft SP, Mims JL 3rd. Unilateral recession and resection in Duane syndrome. J AAPOS. 2001. 5:158–163.