Consecutive Esotropia in Intermittent Esotropia Patients with Immediate Postoperative Overcorrection More Than 17 Prism Diopters

Published on Sep 1, 2007in Korean Journal of Ophthalmology
· DOI :10.3341/KJO.2007.21.3.155
Hyoung Seok Kim1
Estimated H-index: 1
(KU: Korea University),
Young-Woo Suh9
Estimated H-index: 9
(KU: Korea University)
+ 1 AuthorsYoonae A. Cho13
Estimated H-index: 13
(KU: Korea University)
While intermittent exotropia (X(T)) recurs in 20~30% of patients after surgery,1-11 consecutive esotropia (ET) arises in 2~20% because of overcorrection.12-16 Once consecutive ET has occured, the patient can suffer from cosmetic problems and diplopia. Moreover, suppression, amblyopia, and deterioration of stereovision may occur later.17 Lateral incomitancy, medial rectus muscle contracture, and overcorrection of at least 20 prism diopters (PD) immediately after surgery have been reported as risk factors for consecutive ET.9,11,15,18,19 Many studies reported that overcorrection of 11~20 PD immediately after surgery was optimal for the prevention of consecutive ET.6,9,11,16 Raab and Parks4 suggested that in cases of overcorrection that exceeds 17 PD, the occurrence of consecutive ET increased. Kim and Hwang20 reported that 6% of patients who have had overcorrection over 20 PD developed consecutive ET. The purpose of this study was to investigate the incidence and factors in the development of consecutive ET in patients with immediate postoperative overcorrection of at least 17 PD after surgery for X(T).
📖 Papers frequently viewed together
174 Citations
144 Citations
40 Citations
Purpose: We performed this study to evaluate the occurrence of consecutive esotropia after early surgery in the patients with intermittent exotropia less than 4 years of age. Methods: We analyzed the surgical results of 37 patients who underwent surgery before 4 years of age retrospectively. They were followed up at least more than 1 year after surgery. The orthophoria was defined as an exophoria of 0 to 12PD or an esophoria of 0 to 5PD after surgery. The consecutive esotropia was defined as an ...
10 Citations
Purpose : In order to know the outcome in patients with initial overcorrection of 20 or more after the surgery of exotropia. Methods : Sixty-eight patients initially overcorrected 20 or more following surgery for an exotropia were managed with an alternate full time occlusion, echothiopate iodide, or prism glasses for the period of overcorrection. The alternate prism cover test was performed at near and distance during the follow up period. Reoperation was performed if esotropia of 20 or more pe...
7 Citations
2 Citations
#1Helen LewH-Index: 12
#2Jong Bok LeeH-Index: 12
Last. He Seong ParkH-Index: 1
view all 4 authors...
9 Citations
#1Mark S. Ruttum (MCW: Medical College of Wisconsin)H-Index: 17
Abstract Background: Although initial overcorrection is believed to be important after bilateral lateral rectus muscle recessions for intermittent exotropia, not all patients with desirable amounts of initial overcorrection have good final outcomes. The purpose of this study is to evaluate the relationship between initial postoperative and subsequent postoperative motor outcomes in a group of patients operated on for intermittent exotropia. Methods: All patients on whom I performed bilateral lat...
79 CitationsSource
#1Kenneth W. WrightH-Index: 13
#2Peter H. SpiegelH-Index: 6
Sect.1 Normal Development: Embryology Postnatal Development * Sect.2 Practical Aspects of Pediatric Ophthalmology: Pediatric Eye Exam Pediatric Low-Vision Patient Breaking the News Pediatric Eye Trauma * Sect 3 Strabismus and Amblyopia: Anatomy and Physiology of the Extraocular Muscles Laws of Ocular Motility and Introduction to Strabismus Visual Development, Amblyopia and Sensory Adaptations Introduction to Strabismus and the Ocular Motor Exam Sensory Examination Esotropia Exotropia Oblique Ove...
412 Citations
: Many strabismus surgeons recommend an initial surgical overcorrection for intermittent exotropia. Others caution against overcorrection because of possible nasal suppression and amblyopia in children, or because of possible diplopia in adults. We reviewed the records of 69 patients who were initially overcorrected following surgery for an intermittent exotropia. The mean postoperative follow-up was 3.1 years. Eight patients (11.6%) had a persistent overcorrection of 3 prism diopters or more an...
40 CitationsSource
#1Paula M. Edelman (Children's Hospital Los Angeles)H-Index: 3
#2Mary H. Brown (Johns Hopkins University)H-Index: 4
Last. Kenneth W. Wright (Children's Hospital Los Angeles)H-Index: 7
view all 4 authors...
It has been suggested that initial surgical overcorrection of intermittent exotropia (consecutive esodeviation) is a desired immediate postoperative result. The purpose of this paper is to examine ...
49 CitationsSource
#1James M. Richard (University of Oklahoma Health Sciences Center)H-Index: 1
#2Marshall M. Parks (University of Oklahoma Health Sciences Center)H-Index: 14
Abstract The surgical results of 111 consecutive patients with intermittent exotropia treated via bilateral rectus muscle recession and having at least 2 years of follow-up are reviewed. These data are analyzed from a standpoint of three age groups at the time of surgery: younger than 3 years (41 patients), 3 years to younger than 6 years (42 patients), and 6 years to younger than 17 years (28 patients). The initial surgical results for all ages were as follows: 56% satisfactory, 38% undercorrec...
176 CitationsSource
#1William E. ScottH-Index: 34
#2Ronald V. KeechH-Index: 18
Last. A. Jane MashH-Index: 4
view all 3 authors...
• The postoperative changes in motor alignment are documented during a twoyear follow-up period. A moderate overcorrection at the initial postoperative examination resulted in the best alignment one to two years after surgery, regardless of the intermittency of the exodeviation or the presence of amblyopia.
163 CitationsSource
Cited By25
#1Pratik Chougule (LVPEI: L V Prasad Eye Institute)H-Index: 2
#2Mayank Jain (LVPEI: L V Prasad Eye Institute)H-Index: 1
Last. Ramesh Kekunnaya (LVPEI: L V Prasad Eye Institute)H-Index: 14
view all 4 authors...
Purpose: To identify risk factors for abduction limitation in consecutive esotropia following surgical correction of exotropia. To study outcomes of lateral rectus advancement for consecutive esotr...
#1Jin Young Lee (SKKU: Sungkyunkwan University)
#2Ji Eun Song (SKKU: Sungkyunkwan University)H-Index: 1
Last. So Young Han (SKKU: Sungkyunkwan University)H-Index: 2
view all 5 authors...
We evaluated surgical outcomes of bilateral rectus (BLR) recession in patients with intermittent exotropia who underwent diagnostic monocular occlusion. Records of patients with intermittent exotropia who were preoperatively examined one-hour monocular occlusion and underwent BLR recession were reviewed retrospectively. Patients were classified into two groups based on change in exodeviation angle: responders (≥5 change in prism diopters [PD] after occlusion) or non-responders (<5 PD change afte...
#1Kwang Hyun Kim (Hallym University)H-Index: 1
#2Joo Yeon Lee (Hallym University)H-Index: 8
#1Fang XieH-Index: 1
#2Kanxing Zhao (Tianjin Medical University)H-Index: 14
Last. Wei Zhang (Tianjin Medical University)H-Index: 2
view all 3 authors...
Purpose To compare postoperative drift after bilateral lateral rectus recession (BLR) and after unilateral recession combined with medial rectus resection (RR R&R, 155). Exotropic drift was greater in the R&R group in the period between day 1 and 6 weeks and from 6 to 12 months (P 0.05). However, higher overcorrection rates were noted in the BLR group at 6 and 12 months (16.6% vs 6.5 % at 12 months [P = 0.003]). There were more patients with deteriorated stereopsis after surgery in the BLR group...
5 CitationsSource
#1Pratik Chougule (LVPEI: L V Prasad Eye Institute)H-Index: 2
#2Ramesh Kekunnaya (LVPEI: L V Prasad Eye Institute)H-Index: 14
Intermittent exotropia (X(T)) is one of the most common form of strabismus with surgery being the mainstay of treatment. The main goal of surgery is to preserve binocular vision and stereopsis and to prevent its further loss. The decision to operate is mainly based on four aspects: increasing angle of exodeviation, deteriorating control of X(T), decrease in stereopsis for near or distance and quality of life. Bilateral lateral rectus muscle recession and unilateral lateral rectus recession with ...
11 CitationsSource
#1Ichiro Hamasaki (Okayama University)H-Index: 6
#2Kiyo Shibata (Okayama University)H-Index: 3
Last. Fumio ShiragaH-Index: 16
view all 11 authors...
: We investigated variances in the stability and amount of postoperative exodrift among age groups of intermittent exotropia (XPT) patients who underwent unilateral lateral rectus muscle recession and medial rectus muscle resection. We analyzed the cases of 110 consecutive patients who underwent the surgery in 2004-2011, dividing the patients into groups by their age at surgery: <10, 10-19, and ≥20 years. We performed a regression analysis (dependent variable: postoperative exodrift (°); indepen...
2 CitationsSource
#1Ji Won Seo (Inje University)H-Index: 1
#2Hae Jung Paik (Gachon University)H-Index: 4
#1Ju-Yeun Lee (SMC: Samsung Medical Center)H-Index: 6
#2Ga-In Lee (SMC: Samsung Medical Center)H-Index: 4
Last. Sei Yeul Oh (SMC: Samsung Medical Center)H-Index: 12
view all 4 authors...
Purpose To evaluate the effect of initial postoperative deviation on subsequent reoperation in patients with intermittent exotropia and to compare the clinical factors and surgical outcomes between the two surgical failure groups. Methods The medical records of patients who underwent reoperation after failed primary surgery for intermittent exotropia at a single center were reviewed retrospectively. Patients with recurrent intermittent exotropia and consecutive esotropia were considered surgical...
2 CitationsSource
#1Hyeshin Jeon (PNU: Pusan National University)H-Index: 5
#2Jae Ho Jung (PNU: Pusan National University)H-Index: 7
Last. Hee Young Choi (PNU: Pusan National University)H-Index: 12
view all 3 authors...
ABSTRACTPurpose: To investigate the long-term outcomes of intermittent exotropia surgery for children less than 4 years of age.Materials and Methods: Consecutive patients who underwent surgery for intermittent exotropia and had follow-up durations longer than 2 years were recruited. The patients were classified according to age at surgery—the patients of group 1 had undergone surgery before 4 years of age and those of group 2 at or after 4 years of age. Motor success was defined by exodeviation ...
4 CitationsSource