Comparison of Long-term Surgical Outcomes Between Unilateral Recession and Unilateral Recession-Resection in Small-Angle Exotropia

Kim, Hyuna; Yang, Hee Kyung; Hwang, Jeong‐Min

doi:10.1016/j.ajo.2016.03.047

Cited by 19 publications

(11 citation statements)

References 21 publications

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“…The relatively low success rate in our study may be due to the longer follow-up period, difference in preoperative alignments, definition of success and various surgical procedures. In our study, unilateral RR was the only significant factor related to better surgical outcomes in small angle exotropia after multivariate analysis which is in line with our previous reports 27, 28 . In contrast, Dadeya et al 23 found that ULR is an attractive procedure in the treatment Scientific RepoRtS | (2020) 10:4631 | https://doi.org/10.1038/s41598-020-61568-0 www.nature.com/scientificreports www.nature.com/scientificreports/ of exotropia of 25 to 30 PD.…”

Section: Discussionsupporting

confidence: 93%

Comparison of surgery versus observation for small angle intermittent exotropia

Sung

Yang

Hwang

2020

Sci Rep

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in young children with small angle exotropia, making decisions for the individual patient whether to perform surgery or not, and choosing the optimal time for surgical intervention are quite difficult. We aimed to compare the long-term outcomes of small angle intermittent exotropia of 20 prism diopters (PD) or less after observation versus strabismus surgery. A retrospective study was performed on 164 patients aged 3 to 13 who underwent surgical intervention or observation with or without conservative management for intermittent exotropia of 14 to 20 PD. The minimum follow-up period was 2 years. The average follow-up period was 3.9 ± 2.2 years in the observation group and 4.5 ± 2.3 years in the surgery group. At the final examination, the mean angle of deviation at distance was 11.1 ± 8.9 PD in the observation group and 9.0 ± 7.5 PD in the surgery group, which was not significantly different (P = 0.121). Changes in sensory outcome and fusional control were not significantly different between both groups (P = 0.748 and P = 0.968). Subgroup analysis including patients with poor fusional control also showed similar results. By multivariate analysis, the type of surgery, unilateral recess-resect procedure, was the only predictive factor of good motor outcome in the surgery group. In conclusion, long-term surgical outcomes in small angle exotropia did not appear to be more satisfying than observation in terms of motor and sensory outcomes.

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Section: Discussionsupporting

confidence: 93%

Comparison of surgery versus observation for small angle intermittent exotropia

Sung

Yang

Hwang

2020

Sci Rep

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“…Even though we matched the preoperative deviation angle, sex, and the length of follow-up time, the refractive errors, simultaneous vertical strabismus, and the type of surgery were still different between the two groups. The refractive errors, simultaneous vertical strabismus, and the type of surgery all may influence the surgical outcomes in X(T) 11–14 . However, in multivariate weighted cox proportional hazard regression analysis of the Adult and Child groups, none of these factors was a significant risk factor for recurrence.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis of adult and children intermittent exotropia using a matched case-control design

Choi

Noh

Park

et al. 2019

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To compare the surgical outcomes of adult intermittent exotropia (X(T)) patients and matched control children X(T) patients including survival analysis. Fifty-two adult X(T) patients and 129 matched control children X(T) patients were included. Clinical characteristics, survival analysis, and surgical dose-response curves were evaluated and compared between the two groups. The weighted Cox proportional hazards regression analysis was used in order to find risk factors for the recurrence. Using Kaplan-Meier survival analysis, the cumulative probability of survival rate considering recurrence as event of Adult group were 93.97% for one year, and maintained at 88.44% for two, three. four, and five years after surgery. In contrast, those of the Child group were 83.6%, 76.5%, 65.6%, 56.23%, and 40.16% for one, two, three, four, and five years after surgery, respectively. The Adult group had a better event-free survival curve than the Child group as analyzed by a Log-rank test (p = 0.020). According to multivariate weighted Cox regression analysis, the younger age at operation and the larger preoperative angle were significant risk factors for recurrence.

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“…Among these, horizontal strabismus was categorized into one of the following: exodeviation ≥15 prism diopter (PD), exodeviation 1–14 PD, orthotropia, esodeviation 1–9 PD, and esodeviation ≥10 PD. We decided exodeviation ≥15 PD and esodeviation ≥10 PD were clinically significant strabismus, which may be a threshold for strabismus surgery [ 26 – 28 ]; thus, we used this classification for association analyses. A first-degree relative with a history of strabismus was also included.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and risk factors of strabismus in children and adolescents in South Korea: Korea National Health and Nutrition Examination Survey, 2008–2011

et al. 2018

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PurposeTo evaluate the prevalence and risk factors associated with horizontal strabismus in children and adolescents in South Korea.MethodsA total of 5,935 children and adolescents 5–18 years of age who participated in the fourth and fifth Korean National Health and Nutrition Examination Survey (KNHANES IV-V) from July 2008 to December 2011 were evaluated and the prevalence of horizontal strabismus was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the association between demographic, socioeconomic and clinical risk factors and clinically significant exodeviation (≥15 prism diopters [PD]) and esodeviation (≥10 PD).ResultsAmong 5,935 eligible subjects, 84 subjects had clinically significant exodeviation and 13 had clinically significant esodeviation. The overall prevalence of clinically significant horizontal strabismus was 1.6% (95% confidence interval [CI], 1.2–2.1): 1.3% (95% CI, 1.0–1.7) for clinically significant exodeviation and 0.3% (95% CI, 0.1–0.6) for clinically significant esodeviation. Clinically significant exodeviation was associated with amblyopia (adjusted odds ratio [aOR], 6.45; 95% CI, 2.14–19.44), family history of strabismus (aOR, 4.91; 95% CI, 1.71–14.08) and astigmatism ≥1.0 D (aOR, 1.84; 95% CI, 1.13–2.98). Clinically significant esodeviation was associated with hyperopia (aOR, 12.16; 95% CI, 1.31–113.04) and amblyopia (aOR, 4.70; 95% CI, 1.12–19.81). Other demographic, socioeconomic, and clinical variables were not associated with strabismus.ConclusionThis study provides data on the prevalence and independent risk factors for clinically significant exodeviation and esodeviation in a representative population of children and adolescents in South Korea.

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Comparison of Long-term Surgical Outcomes Between Unilateral Recession and Unilateral Recession-Resection in Small-Angle Exotropia

Cited by 19 publications

References 21 publications

Comparison of surgery versus observation for small angle intermittent exotropia

Comparison of surgery versus observation for small angle intermittent exotropia

Survival analysis of adult and children intermittent exotropia using a matched case-control design

Prevalence and risk factors of strabismus in children and adolescents in South Korea: Korea National Health and Nutrition Examination Survey, 2008–2011

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