J Korean Ophthalmol Soc.  2019 Dec;60(12):1257-1262. 10.3341/jkos.2019.60.12.1257.

Outcomes of Augmented Surgery Performed after Simplified Prism Adaptation Testing in Patients with Intermittent Exotropia

• Kim M
• Park S

• KMID: 2466179
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1257

Abstract

PURPOSE
We explored whether the deviation angle in patients with intermittent exotropia was greater when the prism adaptation test was used rather than the prism cover test.
METHODS
From January 2013 to December 2017, we performed the prism cover and adaptation tests on patients with intermittent exotropia. If the deviation angle increased by more than 5 PD after the prism adaptation test, surgery was performed. The outcomes of patients followed-up for more than 1 year after surgery were analyzed retrospectively.
RESULTS
In total, 76 of 100 patients (76.0%) exhibited deviation angle increases of over 5 PD, the mean increase was 9.8 ± 6.3 prism diopters (PD) for near vision and 3.6 ± 3.5 PD for distance vision. Satisfactory motor alignment was achieved in 57 patients; 42 were undercorrected and 1 was overcorrected. The success rate was 62.5% in the non-responder group (n = 24, patients in whom the deviation angle did not increase after prism adaptation) and 68.9% in the full augmentation group (n = 45, in whom the deviation angle was increased). In the partial augmentation group (n = 31), where the surgical target was a 50% increase in the deviation angle, the success rate was lower than in the other groups.
CONCLUSIONS
The preoperative prism adaptation test can be used to determine the angle of deviation and improves the surgical outcomes of patients with intermittent exotropia.

Keyword

Intermittent exotropia; Prism adaptation test; Surgery

MeSH Terms

Exotropia*
Humans
Retrospective Studies

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