J Korean Med Sci.  2019 Oct;34(38):e252. 10.3346/jkms.2019.34.e252.

Factors Associated with the Prognosis after Operation in Children with Recurrent Intermittent Exotropia

Affiliations
  • 1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. ophjun@gmail.com
  • 2Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.

Abstract

BACKGROUND
To describe factors affecting the prognosis after operation for recurrent intermittent exotropia (X[T]) in children.
METHODS
Clinical records of 50 patients who underwent operation for recurrent X(T) by a single surgeon were reviewed. The age at diagnosis of X(T), and first and second operations, deviation angle at distance and near, surgical method, concurrent vertical strabismus, stereoacuity, and Worth's Four Dot (W4D) examination before reoperation were analyzed, along with the postoperative deviation angle. A successful surgical outcome was defined as orthophoria, esodeviation ≤ 5 prism diopters, or exodeviation ≤ 10 prism diopters at distance.
RESULTS
Among the 50 recurrent exotropes who underwent surgery and were followed up for more than 1 year postoperatively, 13 showed recurrent exotropia and 1 showed consecutive esotropia. The mean age at reoperation was 8.49 ± 2.19 years, and the mean duration of postoperative follow-up was 27.78 ± 12.02 months. Good near fusion before reoperation was a significant factor in the success of surgery (P = 0.006). Smaller postoperative deviation angle measured immediately and 2 months after surgery were related to smaller final deviation angle (P = 0.027 and P = 0.022, respectively).
CONCLUSION
Peripheral suppression lowers the success rate of operation for recurrent X(T) in children. Overcorrection rather than orthotropia should be the target of immediate postoperative deviation angle. Peripheral suppression status and immediate and 2-month postoperative deviation angle may be important clues for predicting the final result of operation for recurrent X(T).

Keyword

Recurrent Exotropia; Prognosis; Factors

MeSH Terms

Child*
Diagnosis
Esotropia
Exotropia*
Follow-Up Studies
Humans
Methods
Prognosis*
Reoperation
Strabismus
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr