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Factors Associated with the Prognosis after Operation in Children with Recurrent Intermittent Exotropia

Journal of Korean Medical Science 2019년 34권 38호 p.252 ~ 252
 ( Kim Ji-Ah ) - Seoul National University Bundang Hospital Department of Ophthalmology

 ( Yu Young-Suk ) - Seoul National University College of Medicine Department of Ophthalmology
 ( Kim Seong-Joon ) - Seoul National University College of Medicine Department of Ophthalmology

Abstract


Background: To describe factors affecting the prognosis after operation for recurrent intermittent exotropia (X[T]) in children.

Methods: Clinical records of 50 patients who underwent operation for recurrent X(T) by a single surgeon were reviewed. The age at diagnosis of X(T), and first and second operations, deviation angle at distance and near, surgical method, concurrent vertical strabismus, stereoacuity, and Worth's Four Dot (W4D) examination before reoperation were analyzed, along with the postoperative deviation angle. A successful surgical outcome was defined as orthophoria, esodeviation ≤ 5 prism diopters, or exodeviation ≤ 10 prism diopters at distance.

Results: Among the 50 recurrent exotropes who underwent surgery and were followed up for more than 1 year postoperatively, 13 showed recurrent exotropia and 1 showed consecutive esotropia. The mean age at reoperation was 8.49 ± 2.19 years, and the mean duration of postoperative follow-up was 27.78 ± 12.02 months. Good near fusion before reoperation was a significant factor in the success of surgery (P = 0.006). Smaller postoperative deviation angle measured immediately and 2 months after surgery were related to smaller final deviation angle (P = 0.027 and P = 0.022, respectively).

Conclusion: Peripheral suppression lowers the success rate of operation for recurrent X(T) in children. Overcorrection rather than orthotropia should be the target of immediate postoperative deviation angle. Peripheral suppression status and immediate and 2-month postoperative deviation angle may be important clues for predicting the final result of operation for recurrent X(T).

키워드

Recurrent Exotropia; Prognosis; Factors
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