Surgical Results of Consecutive Exotropia

Rajavi, Zhale; Feizi, Mohadeseh; Mughadasifar, Hoosein; Yaseri, Mehdi; Haftabadi, Narges; Sheibani, Kourosh

doi:10.3928/01913913-20130730-03

Cited by 15 publications

(30 citation statements)

References 15 publications

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“…1,7,8,10–13 We are not aware of any previous studies that have evaluated associations with excessive exodrift per se, but some have evaluated associations with exodeviation recurrence. Two studies found associations between larger preoperative angle of deviation 9,14 and recurrent exodeviation, paralleling our finding of larger preoperative deviation associated with excessive exodrift. Other factors reported as associated with exodeviation recurrence in consecutive exotropia are millimeters of medial rectus advancement 15 and limitation of adduction preoperatively, 11 but these were not found associated with excessive exodrift in the present study.…”

Section: Discussionsupporting

confidence: 90%

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Factors associated with atypical postoperative drift following surgery for consecutive exotropia

Maxfield

Hatt

Jung

et al. 2017

Journal of American Association for Pediatric Ophthalmology and

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Purpose To evaluate the associations of clinical and surgical factors with atypical postoperative drift following surgery for consecutive exotropia. Methods A total of 66 patients with consecutive exotropia (≥10Δ at distance), after historical surgery for esotropia were retrospectively identified at a tertiary medical center. All patients underwent unilateral lateral rectus recession (on adjustable suture) with medial rectus advancement and/or resection. Immediate postoperative target angle was 4Δ–10Δ of esotropia at distance, anticipating mild postoperative exodrift. Actual postoperative drift was calculated as change in distance deviation from immediately postadjustment to 6 weeks. Typical drift was defined as 0Δ–9Δ of exodrift. Excessive exodrift was defined as ≥10Δ. Esodrift was defined as 1Δ or more. Univariate and multiple logistic regression analyses were performed to evaluate for associations with a wide range of clinical and surgical factors. Results Overall there was a median exodrift (4Δ, quartiles 0Δ–10Δ). Of the 66 patients, 18 (27%) showed excessive exodrift; 15 (23%), esodrift. In multiple logistic analyses, larger preoperative distance exodeviation was associated with excessive exodrift (P = 0.01), and non-normal medial rectus attachment status (abnormal [stretched scar, pseudo-tendon], attached to pulley, or behind pulley) was associated with esodrift (P = 0.02). Conclusions Approximately half of patients show atypical drift following unilateral surgery for consecutive exotropia, with larger preoperative distance exodeviation associated with exodrift and non-normal medial rectus muscle status with esodrift. Knowing these associations may help when counseling patients regarding surgical outcomes.

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Section: Discussionsupporting

confidence: 90%

“…5,6 Across previous studies the reported magnitude of exodrift ranges from approximately 4 Δ to 7 Δ 6–9 in the early postoperative period, similar to our finding of 4 Δ over 6 weeks. Nevertheless, reporting averages can obscure individual responses.…”

Section: Discussionsupporting

confidence: 88%

Factors associated with atypical postoperative drift following surgery for consecutive exotropia

Maxfield

Hatt

Jung

et al. 2017

Journal of American Association for Pediatric Ophthalmology and

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“…Mohan et al 17 reported 91% success in a follow-up period of less than 2 years, but noted that this rate decreased to 52% when the follow-up period was longer than 2 years. Additionally, Rajavi et al 18 reported that esotropia etiology did not show any relationship with the success or failure of CXT surgery. In previous studies, controversial results were obtained from various surgical methods, including combined procedures in the treatment of CXT.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of consecutive exotropia: Long-term outcomes

Ceylan¹,

Oguz

Ayyıldız

et al. 2021

European Journal of Ophthalmology

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Purpose: To compare lateral rectus recession (LRc) and medial rectus advancement (MRadv) for correction of consecutive exotropia (CXT). Methods: Of the 43 exotropic patients 20 of them underwent LRc (group 1) and 23 of them underwent MRadv (group 2). Postoperative exodrift, strabismic angle, dose effect relationship were compared with minimum 2 years follow‑up. Results: An average dose-effect in group 2 is higher than group 1 in the early postoperative period, however there was no significant difference at the second year follow-up (p=0,109). An average exodrift after 2 year follow-up was 6,6±7,12 PD in group 1, and 8,13±7,45 PD in group 2. Postoperative overall success rate was 50% in group 1 and 65% in group 2 at the last follow-up. The success rates were not significantly different between the groups (chi-square, p =0.31). Conclusion: Although there was no statistically significant difference at the last follow-up, better results were obtained with MRadv than LRc in the treatment of CXT.

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“…Treatment of consecutive exotropia varies based on viewpoint: either reversal of previous esotropia surgery, [ 10 ] which involve medial rectus (MR) advancement or cooper's dictum [ 11 ] which involve lateral rectus (LR) recession of unoperated or previously resected muscles, or a combination of the above. [ 1 , 12 ]…”

Section: Introductionmentioning

confidence: 99%

“…It is difficult to predict the outcomes of a secondary operation but there is no standardized procedure with only a few studies comparing different surgeries with small series and short-term follow-up. [ 12 , 16 ] In this study, we evaluated the surgical outcomes of MR advancement and LR recession in postoperative consecutive exotropia with single-stage adjustable suture surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgical outcomes between lateral rectus recession and medial rectus advancement for postoperative consecutive exotropia

Han

Lee

et al. 2020

Medicine

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To compare the surgical outcomes of medial rectus advancement and lateral rectus recession in postoperative consecutive exotropia with single-stage adjustable suture surgery. Among 1003 patients who underwent bilateral medial rectus recession between November 1996 and March 2013, the patients who required surgery for consecutive exotopia were retrospectively reviewed. Nineteen patients underwent medial rectus advancement and 15 patients underwent lateral rectus recession. All patients underwent single-stage adjustable surgery under topical anesthesia and were followed up for at least 12 months. The mean follow-up duration was 2.4 years. At final follow-up, a successful surgical outcome was found in 12 patients (63.0%) in the medial rectus advancement group and 14 patients (93.3%) in the lateral rectus recession group ( P = .039). The change in ocular deviation was correlated with the amount of recession ( P = .008) and preoperative angle ( P < .001) in the lateral rectus recession group. Lateral rectus recession showed a higher success rate with predictable and easily performed procedure than medial rectus advancement for the treatment of postoperative consecutive exotropia with adjustable suture.

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Surgical Results of Consecutive Exotropia

Cited by 15 publications

References 15 publications

Factors associated with atypical postoperative drift following surgery for consecutive exotropia

Factors associated with atypical postoperative drift following surgery for consecutive exotropia

Surgical management of consecutive exotropia: Long-term outcomes

Comparison of surgical outcomes between lateral rectus recession and medial rectus advancement for postoperative consecutive exotropia

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