J Korean Ophthalmol Soc.  2016 Oct;57(10):1625-1630. 10.3341/jkos.2016.57.10.1625.

Clinical Course of Consecutive Esotropia after Surgery to Correct Recurrent Intermittent Exotropia

Affiliations
  • 1Department of Ophthalmology, Chosun University School of Medicine, Gwangju, Korea. eyelovehyun@hanmail.net

Abstract

PURPOSE
To analyze the clinical aspects of consecutive esotropia after intermittent exotropia reoperation and study the prognosis and associated risk factors.
METHODS
The present study included 34 patients with intermittent exotropia who underwent reoperation; incidence rate, risk factors, treatment methods and prognosis of the postoperative consecutive esotropia were analyzed.
RESULTS
Of the 34 patients, 12 developed consecutive esotropia that persisted longer than a month after the reoperation; a higher incidence rate was observed in patients with esodeviation greater than 16 prism diopter (PD) on postoperative day 1 and in patients who received unilateral lateral muscle recession and medial muscle resection during the operation (p < 0.05). Conversely, factors such as age, deviation angle, refractive power, anisometropia, lateral incomitance and oblique muscle dysfunction prior to the reoperation did not affect the incidence of consecutive esotropia. The patients who developed consecutive esotropia received conservative treatments such as alternative occlusion therapy and fresnel prism wearing; 10 of 12 patients showed significant clinical improvements.
CONCLUSIONS
Consecutive esotropia frequently occurs after intermittent exotropia reoperation if the patient had esodeviation greater than 16 PD on postoperative day 1 or received unilateral lateral muscle recession and medial muscle resection. The conservative treatments of the consecutive esotropia showed good clinical response and improved prognosis.

Keyword

Clinical course; Consecutive esotropia; Recurrent intermittent exotropia; Risk factor

MeSH Terms

Anisometropia
Esotropia*
Exotropia*
Humans
Incidence
Prognosis
Reoperation
Risk Factors

Cited by  1 articles

Clinical Manifestations of Delayed-onset Consecutive Esotropia after Surgical Correction of Intermittent Exotropia
Daniel Jinhag Baik, Suk-Gyu Ha, Seung-Hyun Kim
Korean J Ophthalmol. 2020;34(2):121-125.    doi: 10.3341/kjo.2019.0108.


Reference

References

1. Oh JY, Hwang JM. Survival analysis of 365 patients with exotropia after surgery. Eye (Lond). 2006; 20:1268–72.
Article
2. Maruo T, Kubota N, Sakaue T, Usui C. Intermittent exotropia abdominal in children: long term outcome regarding changes in binocular alignment. A study of 666 cases. Binocul Vis Strabismus Q. 2001; 16:265–70.
3. Ekdawi NS, Nusz KJ, Diehl NN, Mohney BG. Postoperative abdominals in children with intermittent exotropia from a abdominal-based cohort. J AAPOS. 2009; 13:4–7.
4. Hardesty HH, Boynton JR, Keenan JP. Treatment of intermittent exotropia. Arch Ophthalmol. 1978; 96:268–74.
Article
5. Jang JH, Park JM, Lee SJ. Factors predisposing to consecutive abdominal after surgery to correct intermittent exotropia. Graefes Arch Clin Exp Ophthalmol. 2012; 250:1485–90.
6. Kim HJ, Choi DG. Consecutive esotropia after surgery for abdominal exotropia: the clinical course and factors associated with the onset. Br J Ophthalmol. 2014; 98:871–5.
7. Edelman PM, Brown MH, Murphree AL, Wright KW. Consecutive esodeviation: then what? Am Orthopt J. 1988; 38:111–6.
8. Pratt-Johnson JA, Barlow JM, Tilson G. Early surgery in abdominal exotropia. Am J Ophthalmol. 1977; 84:689–94.
9. Clarke WN, Noel LP. Surgical results in intermittent exotropia. Can J Ophthalmol. 1981; 16:66–9.
10. Jampolsky A. Management of exodeviations. Haik GM, editor. Strabismus Symposium of the New Orleans Academy of Ophthalmology. St. Louis: Mosby;1962. p. 140–56.
11. Keech RV, Stewart SA. The surgical overcorrection of intermittent exotropia. J Pediatr Ophthalmol Strabismus. 1990; 27:218–20.
Article
12. You IC, Yoon KC, Park YG. Assessment of esotropia more than 10PD after surgery of intermittent exotropia. J Korean Ophthalmol Soc. 2003; 44:2278–84.
13. Richard JM, Parks MM. Intermittent exotropia. Surgical results in different age groups. Ophthalmology. 1983; 90:1172–7.
14. Dunlap EA. Overcorrections in exotropia surgery. Manley DR, editor. Symposium on Horizontal Ocular Deviations. St. Louis: The C.V. Mosby Co.;1971. p. 183.
Article
15. Kim HS, Suh YW, Kim Sh, Cho YA. Consecutive estropia in abdominal exotropia patients with immediate postoperative overcorrection more than 17 prism diopters. Korean J Ophthalmol. 2007; 21:155–8.
16. Kim JH, Hwang JM. Initial overcorrection of 20 delta or more after surgery of exotropia. J Korean Ophthalmol Soc. 2003; 44:121–7.
17. Lee EK, Yang HK, Hwang JM. abdominal outcome of prismatic correction in children with consecutive esotropia after bilateral abdominal rectus recession. Br J Ophthalmol. 2015; 99:342–5.
18. Park HS, Kim JB, Seo MS, Park YG. A study on the consecutive esotropia after intermittent exotropia surgery. J Korean Ophthalmol Soc. 1994; 35:1327–34.
19. Moore S. The prognostic value of lateral gaze measurements in intermittent exotropia. Am Orthopt J. 1969; 19:69–71.
Article
20. Kim YH, Choi MY. The effect of Fresnel prism treatment in abdominal esotropia. J Korean Ophthalmol Soc. 2006; 47:1623–9.
21. Lee EK, Hwang JM. Prismatic correction of consecutive esotropia in children after a unilateral recession and resection procedure. Ophthalmology. 2013; 120:504–11.
Article
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr