Early Surgery for Intermittent Exotropia in Children less than 4 Years of Age

Purpose: To determine the result of early surgery for intermittent exotropia for children under 4 year old and the factors which affect it. Methods: The study subjects consisted of 25 children younger than 4 years who had received surgery for intermittent Exotropia. They were followed up for more than 1 year after surgery by the Department of Ophthalmology of the Gachon Medical School, between July 1998 and December 2003. The interval from onset to initial surgery, preoperative deviation angle, dissociated vertical deviation, stereopsis, preoperative patching, type of surgery, and initial postoperative deviation angle were compared and analyzed in a retrospective manner. Results: The average age of the subjects and the preoperative deviation angle were 3.2 years and respectively. The average deviation angle at postoperative year 1 was . Out of the 25 patients, 19 (76%) showed a deviation angle less than 10PD were and 4 (16%) had recurrence of exotropia. Consecutive esotropia occurred in 2 (8%). The clinical factor statistically related to results was the initial postoperative deviation angle. The group who had esophoria of more than 10 PD ( PD) showed 93% orthophoria at postoperative year 1, which was statistically significant. Conclusions: Though a patient be under 4 years old, if their deviation angle is in progress or if non-surgical treatment is ineffective in the case when surgery is delayed, it is presumed that performing surgery at postoperative day 1 with an overcorrection of about 10 PD is preferred.