J Korean Ophthalmol Soc.  2023 Aug;64(8):727-733. 10.3341/jkos.2023.64.8.727.

Survey of Surgical Management in Intermittent Exotropia

• Cho SD
• Hwang JM
• Yang HK

• KMID: 2545000
• DOI: http://doi.org/10.3341/jkos.2023.64.8.727

Abstract

Purpose
To obtain an overview of the surgical practices for the management of intermittent exotropia among experienced surgeons.
Methods
We conducted a survey of members of the Korean Association for Pediatric Ophthalmology and Strabismus, who had experience of > 15 years in strabismus surgery, via e-mail. Surgical methods for basic-type intermittent exotropia, angle of deviation for determining the surgical dose, reasons for surgical dose adjustment, and the postoperative target angle of deviation were analyzed.
Results
Bilateral lateral rectus recession was preferred over unilateral recession and resection for basic-type intermittent exotropia with or without a dominant eye. The preoperative maximum angle of deviation was preferred for determining the surgical dose by 56% of the participants. Two-thirds of the participants preferred to reduce the surgical dose in specific circumstances, lateral incomitancy being the most common reason. In case of true divergence excess-type intermittent exotropia, 47.7% of the participants reduced the surgical dose. The most preferred target angle of deviation at 1 day postoperatively was 11-15 prism diopter esodeviation, as reported by 40% of the participants.
Conclusions
Although experienced surgeons had different surgical preferences for intermittent exotropia, a general trend was found. This survey may be a useful reference for beginners in strabismus surgery.

Keyword

Exotropia, Strabismus, Surgical preference, Survey