Adjustable surgical treatment of adult exotropia: postoperative target angles and surgical success

Chalifoux, Emmanuelle; Alkharashi, Maan; Superstein, Rosanne; Louis, Mélissa; Blais, Claire; Sabzevari, Shamim; Flanders, Michael

doi:10.1016/j.jcjo.2016.02.017

Cited by 7 publications

(10 citation statements)

References 6 publications

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“…In our patients, we observed a mean exodrift of 8 PD after 3 months, which compares well to the literature where an exodrift of 7.4 to 9 PD has been reported 6 months after surgery [5,8] and may increase further with time [6]. This has led to the suggestion to aim for a small esotropic angle in the first week after surgery [5,7].…”

Section: Discussionsupporting

confidence: 89%

“…At the 1-week follow-up, we noticed a slight overcorrection with a mean angle of + 0.76 PD of esotropia, which was lower compared to other studies [5,7,9]. In our patients, we observed a mean exodrift of 8 PD after 3 months, which compares well to the literature where an exodrift of 7.4 to 9 PD has been reported 6 months after surgery [5,8] and may increase further with time [6].…”

Section: Discussionsupporting

confidence: 72%

“…In this large angle cXT subgroup, 54 % of our patients and 44 % in the cohort of Kasi et al [4] had an outcome within 10 PD. A preoperative angle between − 10 to − 20 PD has been associated with a good outcome in cXT surgery [4,7,9]. This applied to only 24 % of our patients versus 37 % of the cohort reported by Kasi et al In these low angle cXT patients, 100 % of our patients had an outcome within 10 PD versus 88 % in the cohort of Kasi et al…”

Section: Discussionmentioning

confidence: 53%

“…However, the study populations differ in the angle of exotropia at surgery. This is relevant, as it has been shown that a higher preoperative angle results in a lower success rate at the final follow-up [4,7,9].…”

Section: Discussionmentioning

confidence: 96%

“…While Cooper has proposed surgery on the previously unoperated eye [3], others suggest re-advancement of the medial rectus muscle and recession of the lateral rectus or a combination of these procedures [4 -10]. Surgical success defined as alignment within ten prism diopters (PD) of orthotropia to allow for peripheral fusion ranges between 56-80 % [4] and depends on the degree of the preoperative angle of deviation [4,7]. In addition to double vision and loss of binocularity, there is a high negative impact on the health-related quality of life in adults with strabismus [11].…”

Section: Strabismus Surgery Of Consecutive Exotropiamentioning

confidence: 99%

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Strabismus Surgery of Consecutive Exotropia

Janeschitz‐Kriegl

Roulez

Wipf

et al. 2020

Klin Monatsbl Augenheilkd

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Purpose The purpose of this study was to determine the surgical outcome, dose-effect (DE), and degree of binocularity in patients undergoing surgery for consecutive exotropia following initial surgery of esotropia. Patients/Methods Twenty-one patients were identified. We analyzed the mean angle of deviation pre- and postoperatively as measured with the alternate prism cover test, DE, and binocularity. Results All patients had had previous strabismus surgery. The surgery for consecutive exotropia had been performed at a mean age of 35.92 ± 18.26 years. In 19 of these patients, surgery of consecutive exotropia involved at least one previously operated extraocular muscle, and the mean interval to the previous surgery was 25.67 ± 16.14 years. The mean angle of deviation (DE) at distance and in the primary position was − 33.43 ± 12.75 prism diopters (PD) preoperatively, + 0.76 ± 7.91 PD 1 week after surgery, and − 7.24 ± 12.14 PD 3 months after surgery. The mean DE was 3.58 ± 1.53 mm/PD at 1 week and 2.70 ± 1.78 mm/PD at 3 months post-surgery. Postoperatively, 62% patients had a binocularity of at least Bagolini positive, 33% had either a positive TNO or Titmus Test, and 24% were Lang I positive (550″). Conclusion Performing strabismus surgery with consecutive exotropia results in restoration of some binocularity in a large number of patients, even in adults, and should be considered as a possibility. The dose-effect is comparable to conventional surgery of exotropia.

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