J Korean Ophthalmol Soc.  2006 Mar;47(3):477-483.

Early Surgery for Intermittent Exotropia in Children less than 4 Years of Age

• Paik HJ
• Sohn HJ

Abstract

PURPOSE: To determine the result of early surgery for intermittent exotropia for children under 4 year old and the factors which affect it.
METHODS
The study subjects consisted of 25 children younger than 4 years who had received surgery for intermittent Exotropia. They were followed up for more than 1 year after surgery by the Department of Ophthalmology of the Gachon Medical School, between July 1998 and December 2003. The interval from onset to initial surgery, preoperative deviation angle, dissociated vertical deviation, stereopsis, preoperative patching, type of surgery, and initial postoperative deviation angle were compared and analyzed in a retrospective manner.
RESULTS
The average age of the subjects and the preoperative deviation angle were 3.2 years and 28.67+/-8.08PD respectively. The average deviation angle at postoperative year 1 was 5.60+/-8.69PD. Out of the 25 patients, 19 (76%) showed a deviation angle less than 10PD were and 4 (16%) had recurrence of exotropia. Consecutive esotropia occurred in 2 (8%). The clinical factor statistically related to results was the initial postoperative deviation angle. The group who had esophoria of more than 10 PD (18.27+/-6.18 PD) showed 93% orthophoria at postoperative year 1, which was statistically significant.
CONCLUSIONS
Though a patient be under 4 years old, if their deviation angle is in progress or if non-surgical treatment is ineffective in the case when surgery is delayed, it is presumed that performing surgery at postoperative day 1 with an overcorrection of about 10 PD is preferred.

Keyword

Consecutive esotropia; Early surgery in patients less than 4 years of age; Intermittent exotropia

MeSH Terms

Child*
Child, Preschool
Depth Perception
Esotropia
Exotropia*
Humans
Ophthalmology
Recurrence
Retrospective Studies
Schools, Medical