Early and delayed consecutive exotropia following a medial rectus faden operation

Abstract

Exotropia appearing immediately after surgery is most likely the result of an individually overdosed operation. This conclusion is not sufficient for delayed exotropia. Motor and sensory instabilities, such as those in patients needing a faden operation with simultaneous shortening of the anterior muscle segment for the treatment of convergence excess with no deviation at far or in patients showing cerebral palsy, seem to increase the risk of delayed consecutive exotropia. The mean interval between the initial surgery and the manifestation of consecutive exotropia is lower than is known from other surgical procedures.

Medial rectus Faden operations with or without recession for partially accommodative esotropia associated with a high accommodative convergence to accommodation ratio

“…In our series, a satisfactory outcome of 76.9% at 1 month postoperatively decreased to 71.3% at the final follow-up visit (mean 4.8 years). Happe et al 11 observed that during the secondary surgery of some Faden operations, the scar between the muscle and the sclera had gradually moved anteriorly. They explained that the procedure's effect was lost over time 11.…”

“…Happe et al 11 observed that during the secondary surgery of some Faden operations, the scar between the muscle and the sclera had gradually moved anteriorly. They explained that the procedure's effect was lost over time 11. Similarly, a decrease in the effects of posterior fixation over time has been reported by Paliaga et al 22 The constant stress on the suture created by MR contraction, coupled with soft tissue remodelling and wound healing after surgery, may diminish the effects of posterior fixation over time 22 23.…”

Consecutive Exotropia following Strabismus Surgery

“…It was reported that for the evaluation of the success of esotropia surgery, short-term follow-up is not adequate [9, 12]. Even in the cases where exotropia does not develop in the immediate postoperative phase, consecutive exotropia may develop years after esotropia surgery [7, 9, 12, 13, 14]. The fact that 16 of our patients changed to exotropia after 2, and 3 patients changed to exotropia after 5 years shows the necessity of a long-term follow-up period in all cases.…”

Computer‐assisted dosage calculation for strabismus therapy in myopic patients

“…The results of our simulations indicate that in our patients the interrelations between biomechanical and sensory effects were probably small: in our esotropic cases the operative effect is constant up to 1 year after treatment; in the six exotropic cases the effect decreases slightly but not significantly 1 year after treatment (exoshift) (Stager et al. 1994; Happe & Suleiman 1999).…”