J Korean Ophthalmol Soc.  2023 Nov;64(11):1071-1077. 10.3341/jkos.2023.64.11.1071.

The Comparison of Long-term Surgical Results for Sensory Exotropia and Comitant Exotropia

• Shin JH
• Kim SJ
• Jung JH

• KMID: 2547871
• DOI: http://doi.org/10.3341/jkos.2023.64.11.1071

Abstract

Purpose
To compare the long-term surgical outcomes of patients with sensory and concomitant exotropia and to define the factors associated with successful surgical outcomes in those with sensory exotropia.
Methods
The medical records of patients with sensory exotropia who underwent operations and were followed-up for at least 2 years were retrospectively reviewed. We enrolled patients exhibiting only best-corrected visual acuities ≤ 20/100 of the operated eyes. Surgical success was defined as a final distance deviation < 10 prism diopters (PD) with the eye in the primary position. Twenty-eight patients operated upon to treat sensory exotropia and 28 who underwent operations to treat concomitant exotropia who did not differ in terms of the gaze deviation angle were matched in terms of age, sex, and the preoperative distance and near distributions; their surgical outcomes were compared. Factors affecting such outcomes were identified using a multivariate Cox’s proportional hazards model.
Results
The mean follow-up times were 91.7 ± 45.8 months in the sensory and 42.6 ± 27.7 months in the concomitant exotropia groups. The cumulative probabilities of surgical success 2 years after surgery were 74.5% in the sensory and 74.4% in the intermittent exotropia groups, thus not significantly different (p = 0.988). The Cox’s proportional hazard model showed that a greater difference between the preoperative distant and near deviations was associated with recurrence (p = 0.091).
Conclusions
The long-term surgical outcomes of patients with sensory and concomitant exotropia were comparable. A high-level near-distance disparity increased the risk of recurrence.

Keyword

Comitant strabismus, Exotropia, Sensory exotropia, Strabismus surgery, Surgical outcome