Clinical analysis of childhood intermittent exotropia with surgical success at postoperative 2 years

Published on Mar 1, 2016in Acta Ophthalmologica3.362
· DOI :10.1111/AOS.12849
Hae Jin Kim1
Estimated H-index: 1
(Sacred Heart Hospital),
Dong Gyu Choi1
Estimated H-index: 1
(Sacred Heart Hospital)
Sources
Abstract
Purpose To analyse the characteristics of children who had maintained the successful outcome at 2 years after surgery for intermittent exotropia. Methods A retrospective study was performed in 216 patients who had undergone intermittent exotropia surgery and had had at least 2 years of follow-up. Surgical outcomes were grouped, according to the angle of deviation at postoperative 2 years, as success (esophoria/tropia ≤ 5 prism dioptres (PD) to exophoria/tropia ≤ 10PD), recurrence (exotropia > 10PD or reoperation within 2 years) or overcorrection (esophoria/tropia > 5PD). We investigated various clinical factors for their possible associations with the surgical outcomes. Results Of the 216 patients, 128 (59%) were assigned to the success group, and 84 (39%) to the recurrence group. According to a univariate analysis, surgical method and the angle of deviation at the postoperative day 1 showed statistically significant associations with the surgical outcome for intermittent exotropia. However, in the results of a logistic regression test, the angle of deviation at distance at postoperative day 1 was the only factor showing a significant association (p = 0.023). Conclusions Early postoperative overcorrection was significantly associated with the maintenance of successful surgical outcome of intermittent exotropia at postoperative 2 years.
📖 Papers frequently viewed together
3 Authors (Eun Hye Jung, ..., Young Suk Yu)
11 Citations
5 Citations
20122.46Eye
3 Authors (Su-Ho Lim, ..., Myung Mi Kim)
33 Citations
References23
Newest
#1Jon Peiter Saunte (UCPH: University of Copenhagen)H-Index: 2
#2Tove Christensen (UCPH: University of Copenhagen)H-Index: 14
8 CitationsSource
#1J. M. Holmes (Mayo Clinic)H-Index: 2
#2Sarah R. Hatt (Mayo Clinic)H-Index: 27
Last. David A. Leske (Mayo Clinic)H-Index: 35
view all 3 authors...
Surgical treatment of childhood intermittent exotropia (XT) is associated with high recurrence rates. In addition, the natural history of intermittent XT has not been rigorously studied and, anecdotally, some cases resolve without surgery. We compared long-term cure rates in children with surgically and non-surgically managed intermittent XT. Children undergoing surgery for intermittent XT who had 5 years follow-up were retrospectively identified. A non-surgical cohort of comparable children was...
13 CitationsSource
#1Dae Seung Lee (SNU: Seoul National University)H-Index: 5
#2Seong Joon Kim (SNU: Seoul National University)H-Index: 15
Last. Young Suk Yu (New Generation University College)H-Index: 30
view all 3 authors...
Aims To classify patients with intermittent exotropia (IXT) according to the level of near stereopsis, evaluate postoperative stereoacuity and assess the surgical outcomes among groups. Methods The records of 137 patients with IXT were reviewed. Patients were divided into three groups based on the degree of stereopsis: good (40–60 arcsec), moderate (80–200 arcsec) and poor (>200 arcsec). These groups were compared with each other with respect to preoperative and postoperative clinical features. ...
11 CitationsSource
#1Su-Ho Lim (Yeungnam University)H-Index: 8
#2B S Hwang (Yeungnam University)H-Index: 1
Last. Myung Mi Kim (Yeungnam University)H-Index: 8
view all 3 authors...
Correction to: Eye (2012) 26, 846–852; doi:10.1038/eye.2012.55; published online 23 March 2012
33 CitationsSource
#1Jin Choi (Inje University)H-Index: 9
#2Ji Woong Chang (Inje University)H-Index: 7
Last. Young Suk Yu (New Generation University College)H-Index: 30
view all 4 authors...
Purpose To conduct a comparison of the long-term surgical outcomes of bilateral lateral rectus recession (BLR) vs unilateral lateral rectus recession–medial rectus resection (RR) in treatment of intermittent exotropia. Design Nonrandomized, retrospective case series. Methods Consecutive patients who underwent BLR or RR for treatment of intermittent exotropia between 2002 and 2006 and had ≥2 years' follow-up were recruited. Surgical outcomes were grouped according to postoperative angle of deviat...
51 CitationsSource
#1Stacy L. Pineles (UCLA: University of California, Los Angeles)H-Index: 22
#2Luke W. Deitz (UCLA: University of California, Los Angeles)H-Index: 2
Last. Federico G. Velez (UCLA: University of California, Los Angeles)H-Index: 23
view all 3 authors...
Background Esotropic overcorrection on postoperative day 1 after surgery for intermittent exotropia is generally thought to increase the likelihood of long-term satisfactory alignment; however, it is unclear why some patients who are initially overcorrected demonstrate recurrent intermittent exotropia whereas others maintain esotropic to orthotropic alignment. Methods The records of all patients who underwent primary surgical correction of intermittent exotropia were reviewed; those with any deg...
18 CitationsSource
#1Jonathan M. Holmes (Mayo Clinic)H-Index: 68
#2David A. Leske (Mayo Clinic)H-Index: 35
Last. Brian G. Mohney (Mayo Clinic)H-Index: 31
view all 5 authors...
Purpose To investigate the course of near stereoacuity in a cohort of children with untreated intermittent exotropia. Methods A total of 95 children ages 2-16 years with untreated intermittent exotropia were identified who had measurements of near stereoacuity using the Preschool Randot (PSR) test on at least 2 successive examinations, with no intervening treatment. Deterioration was defined as a drop of at least 3 octaves, as determined by test–retest data. Alternative secondary analyses were p...
36 CitationsSource
#1Jin Choi (Inje University)H-Index: 9
#2Seong Joon Kim (SNU: Seoul National University)H-Index: 15
Last. Young Suk Yu (New Generation University College)H-Index: 30
view all 3 authors...
Purpose To determine the relationship between initial postoperative deviation and long-term results after surgery for intermittent exotropia. Methods A nonrandomized, retrospective case series. The records of patients who underwent surgery for intermittent exotropia between 2002 and 2006 and had 2 or more years of follow-up were evaluated. Distance alignment at postoperative week 1 was used to predict long-term surgical outcomes. A successful outcome was defined as no recurrence of exodeviation ...
42 CitationsSource
#1Stacy L. Pineles (UCLA: University of California, Los Angeles)H-Index: 22
#2Noa Ela-Dalman (UCLA: University of California, Los Angeles)H-Index: 10
Last. Arthur L. Rosenbaum (UCLA: University of California, Los Angeles)H-Index: 21
view all 5 authors...
Purpose To examine long-term surgical success rates (>10 years) for patients with intermittent exotropia and the risk factors for failure of surgery in these patients. Methods An attempt was made to contact all patients who underwent surgical treatment for intermittent exotropia between the years of 1970 to 1998 with a minimum postoperative follow-up of 10 years. Each patient underwent a detailed sensory and motor examination, including measurements of near and distance stereoacuity, cover testi...
86 CitationsSource
Purpose: To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia. Methods: Forty-eight patients aged between 1 and 10 years who underwent bilateral lateral rectus recession for intermittent exotropia were retrospectively evaluated. Preoperative and postoperative ocular deviations at 1 week, 1 month, and 6 months were analyzed. Full surgical corre...
38 CitationsSource
Cited By11
Newest
#1Jinju Choi (Hallym University)
#2Dong Gyu Choi (Hallym University)H-Index: 4
Purpose While initial overcorrection after exotropia-correcting surgery is widely accepted for a favorable long-term outcome, some have not advocated such overcorrection in younger children owing to concerns regarding rapid deterioration of bifixation ability. This study aimed to evaluate the relationship between initial overcorrection after intermittent exotropia surgery and the surgical outcome in patients aged <4 years. null null Methods In this retrospective study, 391 patients who had under...
1 CitationsSource
#1Tingting Peng (WMU: Wenzhou Medical College)
#2Meiping Xu (WMU: Wenzhou Medical College)H-Index: 4
Last. Xinping Yu (WMU: Wenzhou Medical College)
view all 9 authors...
Purpose null To study the longitudinal rehabilitation of binocular visual function in adolescent intermittent exotropia (IXT) after successful surgery and compare the results with those of a normal population. The role of binocular function in ocular alignment stability was also evaluated postoperatively. null Methods null In this prospective study, 30 adolescents with IXT successfully corrected after 1 month were followed for 12 months, and 30 children with normal vision were enrolled as contro...
Source
#1Yidong Wu (WMU: Wenzhou Medical College)H-Index: 41
#2Meiping Xu (WMU: Wenzhou Medical College)H-Index: 4
Last. Xinping Yu (WMU: Wenzhou Medical College)H-Index: 1
view all 11 authors...
Purpose. To evaluate whether clinical measures of postoperative binocular functions could predict the long-term stability of postoperative ocular alignment in children with intermittent exotropia. Methods. A retrospective study was performed in thirty-nine children (median: 7 years) who have been surgically treated from intermittent exotropia without overcorrection (less than 10 prism diopters [pd] of exodeviation at 1 month postoperatively). Angles of deviation and binocular functions were meas...
1 CitationsSource
Purpose The purpose of this study was to evaluate predictive factors for intermittent exotropia (XT) recurrence after bilateral lateral rectus (BLR) recession. Methods This is a retrospective chart review of patients with XT who underwent BLR recession surgery between January 2007 and March 2017 with at least one postsurgical follow-up. Forty-one medical records were reviewed. Information collected included age, gender, systemic diseases, history of prematurity, family history of eye diseases, v...
Source
#1Yanli Liu (Tianjin Medical University)H-Index: 1
#2Chungao Liu (Hohai University)H-Index: 1
Last. Kanxing ZhaoH-Index: 14
view all 5 authors...
In this paper the optimum timing for the postoperative functional cure of basic intermittent exotropia is explored based on support vector machine (SVM). One hundred and thirty-two patients were recruited in this prospective cross-sectional study with 6 months of follow-up. Examinations included angle of deviation, central and peripheral fusion, controllability, and near and distance stereopsis. Influencing factors of postoperative alignment and stereopsis were analyzed with a chi-squared test a...
1 CitationsSource
#1Xi Wang (Sichuan University)H-Index: 2
#2Wenqiu Zhang (Sichuan University)H-Index: 3
Last. Longqian Liu (Sichuan University)H-Index: 4
view all 5 authors...
PURPOSE: To compare the clinical outcomes of bilateral medial rectus plication and resection for the treatment of convergence insufficiency (CI)-type intermittent exotropia (IXT). METHODS: Fifty-five patients with CI-type IXT were included in this prospective study and were followed for 6 months. The patients were randomized into two groups: the bilateral medial rectus plication (BMRP) group (n = 27) and the bilateral medial rectus resection (BMRR) group (n = 28). The eye examinations of each pa...
2 CitationsSource
#1Gi Hyun Bae (Sahmyook Medical Center)H-Index: 6
#2Seok Hyun Bae (Sacred Heart Hospital)H-Index: 4
Last. Dong Gyu Choi (Hallym University)H-Index: 4
view all 3 authors...
We compare the surgical outcomes of intermittent exotropia of the basic, pseudo-divergence excess (pseudo-DE) and true divergence excess (true DE) types. A study was performed with 342 patients who had undergone surgery for intermittent exotropia of the basic, pseudo-DE or true DE type with a postoperative follow-up period of 6 months or more. The main outcome measures were postoperative angles of deviation at distance and near, and surgical success rates. Surgical success was defined as alignme...
2 CitationsSource
#1Eun Hye Jung (SNU: Seoul National University)H-Index: 4
#2Young Suk Yu (New Generation University College)H-Index: 30
Last. Seong Joon Kim (SNU: Seoul National University)H-Index: 15
view all 3 authors...
Purpose To compare the surgical outcomes between pre- and full-term patients with exotropia and to examine the factors associated with surgical outcomes. Methods This retrospective study included 48 pre- and 432 full-term patients with basic-type exotropia who underwent unilateral or bilateral lateral rectus muscle (ULR or BLR) recession. Preoperative characteristics and surgical outcomes were compared between the pre- and full-term infants. Additionally, factors affecting the surgical outcomes ...
1 CitationsSource
#1Won Jae Kim (Yeungnam University)H-Index: 5
#2Myung Mi Kim (Yeungnam University)H-Index: 8
To compare the rate of exodrift after a second surgery for recurrent exotropia, in patients grouped to fast versus slow exodrift after their first surgery. To determine whether there is a correlation with surgical outcome, and to evaluate the factors associated with fast exodrift. Patients with recurrent intermittent exotropia, who underwent contralateral lateral rectus recession and medial rectus resection as the second surgery and were followed up for 24 months postoperatively between January ...
4 CitationsSource
AIM: To study the factors affecting residual exotropia (>10 PD) at 4-6wk postoperative visit following two rectus muscle surgery for intermittent exotropia [bilateral lateral rectus (LR) recession or unilateral recess resect procedure]. METHODS: A retrospective chart review of patients with intermittent exotropia ≤50 PD who underwent two rectus muscle surgery in between Jan. 2011 to Dec. 2013 was performed. Possible factors were compared between patients with residual exotropia (>10 PD) and succ...
6 CitationsSource