Effect of Visual Acuity on the Surgical Outcomes of Secondary Sensory Strabismus

Abstract

Objectives:To investigate the outcomes of secondary sensory strabismus surgery and to discuss the effect of visual acuity on success.Materials and Methods:The medical records of patients with sensory strabismus who underwent recession-resection on the eye with vision loss were reviewed. Only patients with visual acuity of ≤0.2 in the operated eye were enrolled. Data including age at surgery, visual acuity, etiology of vision loss, preoperative and postoperative deviations, follow-up duration, and surgical outcomes were recorded. Success was defined as a final deviation of ≤10 prism diopters (PD). To evaluate the effect of visual acuity on postoperative success, patients were grouped as follows according to the visual acuity of the operated eye: group 1, visual acuity <0.05; group 2, 0.05-0.1; and group 3, 0.125-0.2.Results:Ten females and 14 males met the inclusion criteria. The mean age at surgery was 21 years (range, 6 to 56 years). The mean preoperative deviation angle was 52.7 PD (range, 20 to 80 PD). Age at surgery, preoperative deviation and follow-up time were similar in patients with esotropia (n=7) and exotropia (n=17) (p>0.05 for all). The success rate was 62.5% at short-term and 42.1% at long-term follow-up. There was no statistically significant difference in short-term success rate among visual acuity subgroups (p=0.331), whereas the difference was statistically significant at long-term follow-up (p=0.002). The long-term success rate was higher in group 3 compared to groups 1 and 2.Conclusion:Better visual acuity seems to be a potential predictor for higher long-term success after strabismus surgery in patients with sensory strabismus.

Surgical results and factors affecting outcome in adult patients with sensory exotropia

“…In this study, 62.5% of patients with sensory exotropia had a successful outcome, with an average of 2.0 ± 1.2 years of follow-up. This result is comparable to those reported in other studies on sensory strabismus surgery, although the inclusion criteria and the length of follow-up vary widely among reports [4][5][6]12].…”

“…Gusek-Schneider et al reported that surgical success in sensory exotropia was correlated with visual acuity in a total 19 patients [8]. Finally, Turan et al reported that better visual acuity may predict better outcome in terms of long-term success in patients with sensory exotropia [4]. However, there were no significant factors associated with surgical outcome in our study.…”

“…Few studies have examined the surgical outcome for secondary strabismus, and in those studies, 50.0-90.6% of patients met the authors' definition of successful outcome, which somewhat varied across studies. Additionally, the inclusion criteria in most studies were not uniform and heterogeneous groups were included, such as patients with sensory exotropia and esotropia, primary and secondary strabismus, and children and adults [4][5][6].…”

“…The factors reported to affect the surgical results after intermittent exotropia surgery vary widely, including age at the time of surgery, preoperative angle of deviation, refractive errors, type of surgery, and early postoperative ocular alignment [7]. However, little is known regarding the factors associated with surgical outcome in sensory exotropia [4,[8][9][10].…”

Unilateral surgery for pediatric sensory exotropia: clinical characteristics and surgical results

“…A lateral rectus recession exceeding 7.0 mm to 8.0 mm behind the equator is also said to reduce abduction significantly [ 28 , 30 ] and causes limitation of ocular rotation [ 31 , 32 ]. Several previous studies of large-angle exotropia have reported success rates ranging from 72 to 80% in bilateral lateral rectus recessions, without significant abduction limitations [ 32 ].…”