The outcome of strabismus surgery in childhood exotropia.

Published on Jan 1, 1993in Eye2.455
· DOI :10.1038/EYE.1994.158
J M Keenan1
Estimated H-index: 1
(Children's of Alabama),
H E Willshaw9
Estimated H-index: 9
(Children's of Alabama)
Sources
Abstract
The results of squint surgery in 42 children with primary, non-paralytic, childhood exotropia are analysed. A ‘favourable outcome’, defined as a final alignment for near and distance within ±10 dioptres of straight, or within ±20 dioptres of straight with evidence of binocular single vision, was achieved in 39 (93%) children. The factors affecting the final outcome are discussed, including age of onset, age at the time of surgery, pre- operative and post-operative amblyopia, refractive error, anisometropia, the surgical procedures used, and postoperative ocular alignment.
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The results of squint surgery in 40 children with congenital esotropia are analysed. A 9favourable outcome9 was achieved in 23 (57.5%) children. The factors affecting the final outcome including ocular alignment in the immediate postoperative period, age at the time of surgery, amblyopia, associated inferior oblique overaction, dissociated vertical deviation, latent or manifest latent nystagmus, and the surgical procedures used are discussed.
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To the Editor. —The randomized multicenter clinical trial described in the September 1990 issue of theArchiveswas designed to determine the efficacy of prism adaptation (PA) in the surgical management of acquired esotropia. 1 In randomized studies, the control population and the experimental population are evaluated before surgery on an equal basis to avoid observer bias. However, in this study, did the PAR/PS patients (prism adaptation responders undergoing surgery for their deviation determine...
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#1Edward L. Raab (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 11
: This study reports observations on the subsequent course of the accommodative component in 139 patients with mixed esotropia after surgery for the nonaccommodative portion of the deviation. An unexpected finding was the presence of a normal distance/near relationship at the time of operation in 69% of these patients. In 40 cases (29%), the accommodative component subsided during the 1st postoperative year. In the remaining patients, the occurrence rate of improvement at longer intervals was si...
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The restoration or maintenance of useful binocular single vision (BSV) represents the ideal outcome in the management of a squinting child. However, in planning such management it is essential to have a clear appreciation of the likelihood of attaining that goal, and what factors will help in its attainment. Using both a literature review and some preliminary information from our own patient database we examine the prospects for BSV in different strabismus groups. We also discuss the techniques ...
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#1C N SmootH-Index: 1
#2J W SimonH-Index: 1
Last. L B NelsonH-Index: 1
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Binocularity was assessed in children who developed large, constant esotropia following bilateral lateral rectus recessions for intermittent exotropia. Nine such patients were identified who warranted medical rectus recession. Seven were finally aligned within 6 prism dioptres after secondary surgery. Stereopsis measured 50 seconds or better in six of these patients and 200 seconds of arc in the seventh. Two patients had residual deviations: one child with 30 prism dioptres of residual esotropia...
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#1Steven E. Rubin (Long Island Jewish Medical Center)H-Index: 6
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: Constant exotropia is uncommon during the first year of life. We retrospectively identified 13 patients with large, constant exotropia during the first year of life which required surgery. Bilateral lateral rectus muscle recessions were done in all 13 cases. Only two patients have required reoperation. The clinical characteristics and management of this unusual condition are similar to those of infantile esotropia.
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#1G K von Noorden (BCM: Baylor College of Medicine)H-Index: 23
Several forms of esotropia with a different pathophysiology that meet the criterion of an onset early in life must be distinguished from essential infantile esotropia. A hypothesis is presented, according to which a delayed development or a congenital defect of retinal disparity sensitivity (motor fusion) in an otherwise normal infant with immature sensory functions causes esotropia under the influence of various strabismogenic factors. Some of these factors are genetically determined, hence the...
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#1H E WillshawH-Index: 1
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Forty-six children awaiting surgery for concomitant esotropia were placed into two matched groups. One group received bilateral medial rectus recessions, while the second group received augmented bilateral medial rectus recessions. By recession the conjunctiva and subconjunctival tissue in addition to the medial rectus we consistently increased the correction obtained. With bilateral medial rectus recession to correct large angle esotropia application of the augmented technique is more likely to...
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Suppression scotomas and retinal projection (retinal correspondence) were measured in six intermittent exotropes during deviation. Measurements used red-green anaglyph stimuli presented on a black background which could be varied from 3.4 minutes of arc to 3 degrees 24'. Results showed non-suppression of all points between the fovea and the diplopia point. Harmonious anomalous retinal correspondence was usually observed. Two subjects had spontaneous changes from anomalous retinal correspondence ...
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#2Dong Gyu Choi (Hallym University)H-Index: 4
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Purpose The correlation between the existence of the preoperative condition of ≥ 10 prism diopter (PD) in patients with basic type of intermittent exotropia (IXT) and postoperative outcomes was analyzed. Method The medical records of patients that underwent surgery for IXT were analyzed retrospectively. The analysis was conducted by dividing the patients into a group with change of < 10 PD (Group 1) and ≥ 10 PD (Group 2) before the time of the surgery. Patients who received at least 6 months of ...
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Objective. To compare the postoperative alignment of patients surgically corrected for esotropia or exotropia 6 weeks and 6 months after surgery.Method. This retrospective study reviewed clinical records of patients who underwent horizontal muscle surgery at the University of the Philippines-Philippine General Hospital from 2010 to 2014. The changes in alignment from 1 week to 6 weeks and from 1 week to 6 months after surgery were compared for overcorrection, undercorrection, and adequate correc...
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#3Lorenz Uhlmann (Heidelberg University)H-Index: 19
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#1Tae Jin Kim (Chosun University)H-Index: 1
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#1Hyeshin Jeon (PNU: Pusan National University)H-Index: 5
#2Jae Ho Jung (PNU: Pusan National University)H-Index: 7
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