Factors affecting surgical outcome of intermittent exotropia

Abstract

PURPOSE:The purpose of this study was to investigate the factors affecting surgical outcome in intermittent exotropia.DESIGNS:This was a retrospective interventional study.METHODS:Intermittent exotropic patients who had undergone surgical correction with a postoperative follow-up period of 1 month or more were included in the study. Surgical success was defined as an alignment between 10 prism diopters (PD) of exotropia or 5 PD of esotropia at 1 month. After data collection, data were analyzed in SPSS version 23 software. The main outcome measures were the factors affecting surgical outcome.RESULTS:We included 101 patients, including 52 (51.5%) male and 49 (48.5%) female. Among them, 62 (61.4%) patients achieved surgical success. Undercorrection was the primary reason of surgical failure. Multivariate regression analysis showed that a larger preoperative angle of deviation was associated with unfavorable surgical outcome (P = 0.053, odds ratio [OR] =0.97, 95% confidence interval [CI] = 0.94–1.00), and the presence of postoperative day 1 (POD 1) diplopia correlated significantly with higher surgical success (P = 0.001, OR = 4.54, 95% CI = 1.80–11.43). The presence of POD 1 diplopia was highly associated with POD 1 esotropia (P = 0.005, OR = 7.26, 95% CI = 1.84–28.58).CONCLUSION:In intermittent exotropia, larger preoperative angle of deviation may predict a lower surgical success rate. Despite a worrisome issue, the presence of diplopia on first POD is associated with immediate postoperative alignment of esotropia and predicts a higher surgical success.

Effect of surgery on sensory eye balance in patients with intermittent exotropia: An observational study

“…This is inconsistent with our results. A large number of studies have shown that the recovery of binocular visual function after strabismus correction is related to many factors, such as the patient's operation age, [29][30][31][32][33][34][35] strabismus type, [32,36] and preoperative strabismus degree. [33] The younger the operation age and the smaller the preoperative strabismus degree, the better the recovery of binocular visual function after surgery.…”

“…The logarithm of the minimum angle of resolution BCVA in the 2 groups was 0 (0-0.0) and 0 (0-0) with no significant difference (Z = −1.462, P = .144). The mean preoperative strabismus degree at 33 cm and 6 m accommodative targets in the IXT group was35.5 (30-45) and 30 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), respectively. The mean postoperative strabismus degrees measured at 33 cm and 6 m accommodative targets in the IXT group were −3 (−6−0) and −2 (−6-), respectively.…”