Comparison of surgery versus observation for small angle intermittent exotropia

Abstract

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.

Study on Binocular Accommodative Function in Children With Different Types of Intermittent Exotropia

“…Accordingly, the increased convergence will result in greater accommodation ( 14 ). Some studies have found that the binocular AF of patients with IXT is significantly lower than that of a control group, which is consistent with the results of this study ( 15 ).…”

Evaluation of unilateral lateral rectus muscle recession for correction of small-angle intermittent exotropia

“…Four patients complained of lateral incomitance and limitation of abduction at last follow up at 6th months. Jae Yun Sung et al [24] This study compared the surgical outcomes of patients who had surgical correction with patients who were just followed for a minimum of 2 years for small angle exotropia of 20 prism dioptres (PD) or less. There was no significant difference in the surgical success rate between the groups at the final follow-up.…”

Diagnostic performance of the Spot vision photoscreener for the detection of exodeviation in preschool‐aged children

“…Fusional control was also assessed with repeated trials of the cover‐uncover test at distance. Fusional control of exodeviation was classified into three levels according to the frequency of manifest exodeviation and refixation capacity: good (exodeviation manifests only after the cover test and fusion restarts immediately without blinking or refixation), fair (blinks or refixation to control the exodeviation) and poor (exodeviation manifests spontaneously, occurs in natural environments without any form of fusion disruption and persists after blinking and refixation efforts) 19–21 . Furthermore, we investigated cases requiring strabismus surgery more than 1 year after their initial examination.…”