Exotropia Is the Main Pattern of Childhood Strabismus Surgery in the South of China: A Six-Year Clinical Review

Abstract

Purpose. To evaluate the distribution pattern and changes of strabismus surgery in children based on the data collected from a local eye hospital in the south of China between 2006 and 2011. Methods. A retrospective analysis of all strabismus surgeries in children (<18 years) performed in the Eye Hospital of Wenzhou Medical University between 2006 and 2011 using the integrated information system. Result. A total of 2,219 strabismus surgeries were performed during the study period, with concomitant exotropia (44% of all surgeries) more than esotropia (27%, χ 2 = 42.7, p < 0.001). Total number of surgeries increased from 250 in 2006 to 508 in 2011, with a significant increase in concomitant exotropia: 38% of all surgeries in 2006 increased to 47% in 2011 (χ 2 = 29.4, p < 0.001). The increase of intermittent exotropia was approximately 26% of all increments of strabismus surgery between 2006 and 2011. Conclusion. Surgery for childhood exotropia was more frequent than esotropia in China. The proportion of exotropia progressively increased, while the proportion of esotropia decreased during these years. Intermittent exotropia was the main increment of strabismus surgery. Further population-based studies are needed to confirm the proportion of surgery and whether the incidence of strabismus surgery increased in China.

Can Clinical Measures of Postoperative Binocular Function Predict the Long-Term Stability of Postoperative Alignment in Intermittent Exotropia?

“…Fusional compensatory mechanisms have been suggested to maintain eye alignment in this type of strabismus [ 1 , 5 , 6 ], allowing the development of binocular function. A common approach for clinicians to treat the patients with a poor control of exodeviation is strabismus surgery [ 1 , 2 , 7 ]. However, whether strabismus surgery benefits the patients longitudinally is nebulous because the recurrence rate of IXT after surgery has been shown to be high [ 8 – 11 ].…”

Characterization of Intelligence in Children with Exotropia

“…Intermittent exotropia (X(T)) and constant exotropia (XT) are the two major types of exotropia [1]. Epidemiological studies show that the prevalence of exotropia is relatively higher in Asian children than in Western children [2,3,4,5,6,7,8]. In China, the prevalence of exotropia is reported as ranging from 0.16% to 4.57% in children [9,10].…”

Lässt sich anhand von klinischen Variablen der Binokularfunktion die langfristige Stabilität der postoperativen Augenstellung nach Korrektur einer intermittierenden Exotropie vorhersagen?

“…Für den Erhalt der Augenstellung bei dieser Form des Schielens wurden kompensatorische fusionale Mechanismen ins Spiel gebracht [1, 5, 6], die die Ausbildung einer Binokularfunktion erlauben. Ein häufiger Behandlungsansatz bei Patienten, die die Exodeviation (Außenschielen) schlecht kontrollieren können, ist die Schieloperation [1, 2, 7]. Allerdings ist unklar, ob eine Schieloperation den Patienten im Langzeitverlauf hilft, da nach entsprechenden Operationen eine hohe Rezidivrate von intermittierender Exotropie beschrieben wurde [8-11].…”