Factors Associated with Surgical Outcomes of Intermittent Exotropia in Children

Abstract

Purpose To evaluate factors associated with surgical outcomes of children with intermittent exotropia (IXT). Methods A retrospective study was performed for 125 patients who had undergone intermittent exotropia surgery with at least one year of follow up. Surgical outcomes were grouped as success (esophoria/tropia ≤ 5 prism diopers (PD) to exophoria/tropia ≤ 10 PD), failure (esophoria/tropia > 5PD or exophoria/tropia > 10PD) according to the angle of deviation at postoperative one year. We investigated subjects’ clinical and demographic factors including magnitude of exo-deviation, stereoacuity at near and distance, and response to patching at 3 months after patching. Factors associated with surgical outcomes were then determined through univariate and multivariate analyses. Results Of a total of 125 patients, 102 (81.6%) were assigned to the success group and 23 (18.4%) to the failure group. Univariate analysis revealed that absence of anisometropia, smaller preoperative near exodeviation, better stereopsis at near, magnitude of deviation at postoperative day 1, and good response to preoperative patching were significantly associated with surgical success for IXT at postoperative one year. In multivariate analysis, distant esotropic magnitude of deviation at postoperative day 1 was the only factor affecting successful surgical outcome. Conclusions Preoperative patching and small distant esotropia at postoperative day 1 are prognostic factors that could be altered in an effort to provide a successful surgical outcome.