Early versus late surgery for infantile exotropia.

Published on Nov 1, 2017in Journal of Aapos1.339
· DOI :10.1016/J.JAAPOS.2017.08.006
Kun Hoo Na3
Estimated H-index: 3
(KU: Korea University),
Seung Hyun Kim29
Estimated H-index: 29
(KU: Korea University)
Sources
Abstract
Purpose To determine whether age at surgery influences postoperative outcome in infantile exotropia. Methods This longitudinal, retrospective study included children who underwent bilateral lateral rectus recession between 2004 and 2012 for an exotropia with onset by 12 months of age. Surgical outcomes were considered failures if recurrence with exodeviation of >8Δ or overcorrection with esodeviation of >5Δ developed during postoperative period. Univariate and multivariate analyses were conducted to compare the association of age at surgery with development of recurrence and overcorrection. Results A total of 93 children were included. Mean age at surgery was 3.2 years. At a mean follow-up of 3.6 years, 19 of 93 patients (20.4%) experienced recurrence and 3 (3.2%) had overcorrection. In the multivariate analyses, increased age at surgery was associated with higher risk for recurrence (OR = 1.031 per 1-month; 95% CI, 1.003-1.060). In subgroup analyses, the association was significant only in the constant exotropia group (OR = 1.410; 95% CI, 1.037-1.917) and not in the intermittent exotropia group (OR = 0.995; 95% CI, 0.938-1.056). In both groups, overcorrection was not associated with any factors, including age at surgery. Conclusions Older age at surgery was associated with risk of recurrence in infantile exotropia with constant deviation, but it was not correlated with surgical outcomes for patients with intermittent exotropia in this study.
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References20
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To evaluate the long-term surgical outcomes and the clinical features between infantile-onset constant and intermittent exotropia.The medical records of 67 patients diagnosed as having infantile exotropia before 12 months of age who underwent surgery were reviewed retrospectively. Patients were divided into intermittent exotropia and constant exotropia groups based on presentation before surgery. All patients underwent bilateral lateral rectus recession. Preoperative and postoperative clinical f...
6 CitationsSource
#1Ki Tae Nam (KU: Korea University)H-Index: 4
#2Seung Hyun Kim (KU: Korea University)H-Index: 29
Background To investigate the optimal surgical dose for treating infantile exotropia. Methods In this retrospective study, clinical records of 44 children who had undergone bilateral lateral rectus recessions before 4 years of age for an exotropia present before 12 months of age were studied. Children had 1 year of follow-up after surgery. Patients were separated into those who had traditional surgery and those who received a reduced recession of their lateral recti. Results The traditional surg...
5 CitationsSource
Abstract Objective To evaluate age at surgery and duration of misalignment, which affect surgical outcomes of infantile exotropia in healthy children younger than 1 year. Methods The charts of 39 patients who have at least 1 year of follow-up period after surgery with a diagnosis of early-onset exotropia were reviewed retrospectively. Patients were divided into 2 groups (preoperative deviation [PD]): success (exodeviation ≤8 PD or esodeviation ≤5 PD at 1 year postoperatively without reoperation ...
12 CitationsSource
#1Yong Min Choi (KU: Korea University)H-Index: 3
#2Seung Hyun Kim (KU: Korea University)H-Index: 29
Purpose To compare the clinical outcomes and characteristics of 2 different types of early-onset exotropia on the basis of stereopsis outcome. Design Retrospective case series. Participants A total of 24 patients with newly diagnosed exotropia before 12 months of age and at least 1 year of follow-up after surgery. Methods The clinical records of all patients were reviewed. Patients were divided into 2 groups according to stereopsis. The presumable early-onset intermittent exotropia (EIE) group w...
21 CitationsSource
#1Jason C. S. Yam (Tung Wah Eastern Hospital)H-Index: 19
#2Patrick K W Wu (Tung Wah Eastern Hospital)H-Index: 5
Last. Simon T. C. Ko (Tung Wah Eastern Hospital)H-Index: 8
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Purpose To compare postoperative drift after bilateral lateral rectus recession for infantile exotropia (XT) and for intermittent XT and to compare initial postoperative alignment with long-term motor outcome. Methods Medical records of all patients with infantile exotropia or intermittent exotropia who had undergone bilateral lateral rectus muscle recession surgery with a follow-up longer than 3 years were reviewed. The pre- and postoperative angles of deviation at distance and at near and post...
40 CitationsSource
#1Ji Hye Park (KU: Korea University)H-Index: 7
#2Seung Hyun Kim (KU: Korea University)H-Index: 29
Purpose To evaluate the clinical features and the risk factors of recurrence in infantile exotropia. Design Retrospective, observational case series. Methods The clinical records of 20 infantile exotropia patients who underwent exotropia surgery were reviewed retrospectively. Patients were divided into 2 groups according to the amount of exodeviation present at 1 year after surgery. Preoperative patient characteristics and postoperative alignments were evaluated at 1 day and 1, 3, 6, and 12 mont...
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#1Konstandina Koklanis (Royal Children's Hospital)H-Index: 8
#2Zoran Georgievski (La Trobe University)H-Index: 4
Introduction: The surgery of choice for intermittent exotropia (XT) continues to be debated, with little evidence that one procedure provides a more successful outcome than the other in the longer term. Many factors, however, may potentially influence the outcome of strabismus surgery for intermittent XT. This study aimed to investigate factors associated with the recurrence of an exo-deviation following horizontal muscle surgery for intermittent XT of the divergence excess type. Methods: We ret...
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#1Kenneth W. WrightH-Index: 13
#2Yi Ning J. StrubeH-Index: 4
Amblyopia Treatment.- Principles of Strabismus Surgery.- Infantile Esotropia.- Acquired Esotropia.- Exotropia.- Complex Strabismus.- Cranial Nerve Palsies.- Section Two - Surgical Techniques.- Surgical Anatomy.- Basic Surgical Techniques - Do's and Don'ts.- Conjunctival incisions.- Limbal Rectus Muscle Recession.- Fornix Rectus Muscle Recession.- Rectus Muscle Tightening Procedures.- Adjustable Suture Techniques.- Topical Anesthesia Strabismus surgery.- Rectus Muscle Offsets and the Y-Split Proc...
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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 ...
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#1Hae Jung PaikH-Index: 2
#2Hye Bin Yim (CUA: The Catholic University of America)H-Index: 1
: To evaluate the effects of early surgical intervention in infantile exotropia on the motor and sensory functions, we reviewed the records of 17 subjects diagnosed with exotropia before the age of 12 months, receiving surgery before the age of 24 months, with a follow-up period greater than one year, between 1996 and 2000. Of the 17 subjects (6 intermittent, 11 constant), 14 (82%) (6 intermittent, 8 constant) had a final horizontal deviation of <10 PD, with 3 (18%) needing a re-operation. Fusio...
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#1Yi Dong (Tianjin Medical University)H-Index: 3
#2Li Nan (Tianjin Medical University)H-Index: 1
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Aim To compare the outcomes between early surgery and late surgery for intermittent exotropia (IXT) with a Meta-analysis. Methods Scientific databases including PubMed, Embase, Web of Science, Cochrane and China National Knowledge Infrastructure were searched prior to December 16, 2019. From this broad database search, we performed some Meta-analysis including eleven independent studies, to further evaluate the outcome(s) when comparing early versus late surgery for IXT. The boundaries between e...
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#1Zhale Rajavi (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 10
#2Hamideh Sabbaghi (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 7
Last. Kourosh SheibaniH-Index: 9
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PURPOSE: We aimed to determine the long-term motor and sensory outcomes of patients with infantile exotropia. METHODS: In this longitudinal retrospective (historical cohort) study, the records of 76 patients with infantile exotropia were Studied. Subjects with constant exotropia manifesting before the age of 1 year who were at least 5 years old at recruitment time between 2008 and 2017 were included. RESULTS: The medical records of 26 patients were excluded due to not participating in follow-up ...
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#1Kun Hoo Na (KU: Korea University)H-Index: 3
#2Seung Hyun Kim (KU: Korea University)H-Index: 29
Abstract Purpose To determine whether age of onset influences surgical outcomes in infantile exotropia. Methods The medical records of patients at our tertiary care facility who underwent bilateral lateral rectus recession for infantile exotropia during the period 2004-2013 were reviewed retrospectively. Patients were grouped by onset age: 6 months or earlier (E6 group) or later than 6 months (L6 group). Motor outcomes, near stereoacuity, and distance fusional status in both groups were evaluate...
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