Surgery at early versus late for intermittent exotropia: a Meta-analysis and systematic review.

Published on Apr 18, 2021in International Journal of Ophthalmology1.779
· DOI :10.18240/IJO.2021.04.16
Yi Dong4
Estimated H-index: 4
(Tianjin Medical University),
Li Nan2
Estimated H-index: 2
(Tianjin Medical University)
+ 0 AuthorsYu-Yan Liu
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 early and late surgery and the surgery methods were not inconsistent, so subgroup analyses were conducted by different boundaries of age at surgery and different surgical approaches. The pooled odds ratios (ORs) and the 95% confidence interval (CI) were estimated according to the random-effects model for high heterogeneity between studies. Results Eleven retrospective studies were included in this Meta-analysis. No significant difference between early and late surgery was observed for IXT patients (ORFirst follow-up=0.88, 95%CI 0.53-1.44, P=0.61; ORFinal follow-up=1.48, 95%CI 0.94-2.31, P=0.09). However, sensitivity analysis performed by sequentially omitting individual studies showed that the final follow-up result was not stable. Subgroup analyses revealed that an earlier surgical procedure could lead to a better outcome in the 4-year boundary subgroup as well as the bilateral lateral rectus recession (BLR) subgroup for the final follow-up (OR4y=2.64, 95%CI 1.57-4.44, P=0.00; ORBLR=2.25, 95%CI 1.36-3.74, P=0.00). Conclusion Early surgery for IXT provides a better long term follow-up outcome when patients are younger than 4 years old or choose the BLR surgical method.
#1Michael X. Repka (Johns Hopkins University)H-Index: 68
Last. David K. Wallace (IU: Indiana University)H-Index: 51
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Abstract Purpose To determine whether age at surgery is associated with surgical outcome of intermittent exotropia (IXT) at 3 years. Design Secondary analysis of pooled data from a randomized trial Methods 197 children 3 to > 2 octaves, at any masked examination; or reoperation without meeting any of these criteria. Results The cumulative probability of a suboptimal surgical outcome by 3 years was 28% (19 of 72) for children 3 to Conclusions This analysis suggests that in children with IXT, youn...
#1Pratik Chougule (LVPEI: L V Prasad Eye Institute)H-Index: 3
#2Ramesh Kekunnaya (LVPEI: L V Prasad Eye Institute)H-Index: 15
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 ...
Purpose To determine the prevalence rate of amblyopia and strabismus in Chinese Hani ethnic school-aged children. Methods All grade 1 and grade 7 students in Mojiang Hani Autonomous County, located in southwest China, were invited for comprehensive eye examinations performed by experienced ophthalmologists and optometrists, including visual acuity, ocular alignment and movements, cycloplegic autorefraction, anterior segment and fundus examinations. Standard definitions of amblyopia and strabismu...
#1Kun Hoo Na (KU: Korea University)H-Index: 3
#2Seung Hyun Kim (KU: Korea University)H-Index: 34
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 conducte...
PURPOSE:To report the outcomes in patients undergoing surgical correction of intermittent exotropia and to compare the age at surgery to motor and sensory success. METHODS:This was a retrospective cohort study. The results of patients with intermittent exotropia treated with surgery over a 4-year period were reviewed. Patients were divided into two groups based on age at first surgery (<4 years vs. ≥4 years), and motor and sensory outcomes were compared between the two groups. RESULTS:One hundre...
#1Hyeshin Jeon (PNU: Pusan National University)H-Index: 4
#2Jae Ho Jung (PNU: Pusan National University)H-Index: 7
Last. Hee Young Choi (PNU: Pusan National University)H-Index: 13
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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 ...
#1Di Zou (UCL: University College London)H-Index: 1
#2Clémentine Casafina (Royal Free London NHS Foundation Trust)H-Index: 1
Last. Saurabh Jain (UCL: University College London)H-Index: 4
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Background In patients with moderate- to large-angle exotropic deviations, surgical correction remains the definitive treatment. The purpose of this study was to identify preoperative factors that correlate with surgical success and to produce a binomial model that predicts success based on preoperative factors. Methods We performed a retrospective review of patients with intermittent exotropia who underwent uniocular recession-resection surgery. Success was defined as ocular deviation ≤10 Δ exo...
#1Alison Bruce (Ebor: University of York)H-Index: 8
#2Gillian Santorelli (University of Leeds)H-Index: 15
ABSTRACTPurpose: To determine the prevalence, types and early-life risk factors associated with strabismus in a multi-ethnic birth cohort of children aged 4-5 years in the first year of school.Methods: Data were collected prospectively over a 3-year period (2012-2015) from children participating in the vision screening program provided by orthoptists and carried out in schools located in the city of Bradford, UK. Prevalence of strabismus was determined for 17,018 children aged 4 to 5 years. Data...
#1Dadong Guo (SDUTCM: Shandong University of Traditional Chinese Medicine)H-Index: 13
#2Jian Feng Wu (SDUTCM: Shandong University of Traditional Chinese Medicine)H-Index: 9
Last. Hongsheng Bi (SDUTCM: Shandong University of Traditional Chinese Medicine)H-Index: 15
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Objective To assess stereoacuity in a population-based sample of children and to examine ocular and systemic parameters related to stereoacuity. Methods Using a random cluster sampling method, four- to 18-year-old children from kindergartens, elementary schools, junior high schools and senior high schools from a rural area and an urban area in the East Chinese province of Shandong were included in the school-based cross-sectional study. All participants underwent a comprehensive eye examination ...
Last. Jason C. S. YamH-Index: 19
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The Natural Course of Intermittent Exotropia over a 3-year Period and the Factors Predicting the Control Deterioration
Cited By1
#1Dong Hyun Kim (Seoul National University Bundang Hospital)H-Index: 1
#2Hee Kyung Yang (Seoul National University Bundang Hospital)H-Index: 20
Last. Jeong-Min Hwang (Seoul National University Bundang Hospital)H-Index: 26
view all 3 authors...
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