Survival analysis of adult and children intermittent exotropia using a matched case-control design

Abstract

To compare the surgical outcomes of adult intermittent exotropia (X(T)) patients and matched control children X(T) patients including survival analysis. Fifty-two adult X(T) patients and 129 matched control children X(T) patients were included. Clinical characteristics, survival analysis, and surgical dose-response curves were evaluated and compared between the two groups. The weighted Cox proportional hazards regression analysis was used in order to find risk factors for the recurrence. Using Kaplan-Meier survival analysis, the cumulative probability of survival rate considering recurrence as event of Adult group were 93.97% for one year, and maintained at 88.44% for two, three. four, and five years after surgery. In contrast, those of the Child group were 83.6%, 76.5%, 65.6%, 56.23%, and 40.16% for one, two, three, four, and five years after surgery, respectively. The Adult group had a better event-free survival curve than the Child group as analyzed by a Log-rank test (p = 0.020). According to multivariate weighted Cox regression analysis, the younger age at operation and the larger preoperative angle were significant risk factors for recurrence.

The subjective controllability of exotropia and its effect on surgical outcomes in patients with intermittent exotropia

“…In patients with controllability, a larger preoperative amount of deviation at distance and near was significantly associated with recurrence. These results are consistent with those of previous studies on the prognostic factors of surgical outcomes in patients with intermittent exotropia [ 2 – 4 ]. Although patients with controllability had relatively better binocularity, those with a large amount of exotropia were more likely to experience recurrence after surgical treatment.…”

“…Intermittent exotropia is the most common type of strabismus among Asians, particularly Koreans [1]. Exodrift and recurrence can occur after surgical treatment in these patients [2][3][4]. Previous studies have evaluated the clinical factors associated with surgical outcomes to predict the prognosis after surgical treatment [2][3][4].…”

“…Exodrift and recurrence can occur after surgical treatment in these patients [2][3][4]. Previous studies have evaluated the clinical factors associated with surgical outcomes to predict the prognosis after surgical treatment [2][3][4]. The clinical factors mainly evaluated in patients with intermittent exotropia included the amount of ocular exodeviation, level of control, and results of stereoacuity tests.…”

Effectiveness of Strabismus Surgery in Intermittent Exotropia and Factors Influencing Outcome

“…Just like Thorisdottir et al and us, many other authors reported the relationship between large preoperative squint angles and negative surgical outcomes [5,6,[13][14][15][16]. This result is very likely a multifactorial condition and can be a result of measurement inaccuracy, dosing, and other individual factors.…”

“…Many studies have already looked at factors influencing surgical outcome. Some suggest that large preoperative squint angles may have a negative impact on surgical success [5,6,[13][14][15][16]. Others say that the age of patients at surgery affects outcome [11,[16][17][18][19].…”