J Korean Ophthalmol Soc.  2008 Jul;49(7):1108-1113. 10.3341/jkos.2007.49.7.1108.

The Clinical Features of Patients with Early Recurrence and with Orthophoria After Intermittent Exotropia Surgery

• Ko BW
• Shin SY

• KMID: 1476965
• DOI: http://doi.org/10.3341/jkos.2007.49.7.1108

Abstract

PURPOSE: To analyze the clinical features of patients with exodeviation of more than 15 prism diopters (PDs) within one month and with orthophoria over three years after surgical correction of intermittent exotropia.
METHODS
The early recurrence group consisted of patients with a final distance and near exodeviation more than 15PDs within one month after surgical correction of intermittent exotropia. The surgical success group was defined as patients with orthophoria over three years after surgical correction of intermittent exotropia. Sex, age at onset and surgery, office control status, refraction status, A-V pattern, preoperative and postoperative angles of ocular deviation, binocular sensory status, and the presence of diplopia on postoperative one day were retrospectively investigated and compared between these two groups.
RESULTS
Out of a total of 68 patients, early recurrence occurred in 33 patients, and success was achieved in 35 patients. Factors including sex, age at onset and surgery, office control status, and diplopia on postoperative one day did not differ between the two groups. Preoperative near-angles of ocular deviation, A-V pattern of strabismus, preoperative stereopsis, and the range of postoperative overcorrection contributed to early recurrence.
CONCLUSIONS
Factors related to early recurrence were larger preoperative near-angles of ocular deviation, presence of A-V pattern, poor preoperative stereopsis, and a smaller amount of overcorrection on postoperative day 1.

Keyword

Early recurrence; Intermittent exotropia

MeSH Terms

Ambulatory Surgical Procedures
Depth Perception
Diplopia
Exotropia
Humans
Recurrence
Retrospective Studies
Strabismus
Telescopes

Reference

References

1. Raab EL, Parks MM. Recession of the lateral recti. Early and late postoperative alignment. Arch Ophthalmol. 1969; 82:203–8.

2. Jampolsky A. Treatment of exodeviation. Trans New Orleans Acad Ophthalmol. 1986; 34:201–34.

3. Clarke WN, Noel LP. Surgical results in intermittent exotropia. Can J Ophthalmol. 1981; 16:66–9.

4. Keenan JM, Willshaw HE. The outcome of strabismus surgery in childhood exotropia. Eye. 1994; 8:632–7.

5. Paik HJ, Sohn HJ. Early Surgery for Intermittent Exotropia in Children less than 4 Years of Age. J Korean Ophthalmol Soc. 2006; 47:477–83.

6. Kim SJ. Comparison of surgical results between bilateral recession and unilateral recession-resection in intermittent exotropia. J Korean Ophthalmol Soc. 1992; 33:95–100.

7. Ko KH, Min BM. Factors related to Surgical Results of Intermittent Exotropia. J Korean Ophthalmol Soc. 1996; 37:179–84.

8. Heo NH, Paik HJ. The relationship between binocular function and the surgical outcome of intermittent exotropia. J Korean Ophthalmol Soc. 2001; 42:1588–93.

9. Beneish R, Flanders M. The role of strabismus and early postoperative alignment in long-term surgical results of intermittent exotropia. Can J Ophthalmol. 1994; 29:119–24.

10. Gill MK, Drummond GT. Indications and outcomes of strabismus repair in visually mature patients. Can J Ophthalmol. 1997; 32:436–40.

11. Lee JY, Choi DG. The Clinical Analysis of Recurrence After Surgical Correction of Intermittent Exotropia. J Korean Ophthalmol Soc. 2002; 43:2220–6.

12. Gezer A, Sezen F, Nasri N, Gözüm N. Factors influencing the outcome strabismus surgery in patients with exotropia. J AAPOS. 2004; 8:46–9.

13. Pratt-Johnson JA, Barlow JM, Tillson G. Early surgery in intermittent exotropia. Am J Ophthalmol. 1977; 1:88–91.

14. Edelman PM, Brown MH, Murphee AL, Wright KW. Consecutive esodeviation. the what? AM Orthoptic J. 1988; 38:111–6.

15. Jampolsky A. Characteristics of suppression in strabismus. Arch ophthalmol. 1955; 54:683–96.