Exotropic drift and ocular alignment after surgical correction for intermittent exotropia. 2010

Po-Lin Leow, and Simon T C Ko, and Patrick K W Wu, and Clement W N Chan
Hong Kong Island Cluster Ophthalmology Service, Hoong Kong, The People's Republic of China.

OBJECTIVE To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia. METHODS Forty-eight patients aged between 1 and 10 years who underwent bilateral lateral rectus recession for intermittent exotropia were retrospectively evaluated. Preoperative and postoperative ocular deviations at 1 week, 1 month, and 6 months were analyzed. Full surgical correction was attempted in all patients. Motor success was defined as ocular deviation within 10 prism diopters of orthophoria at 6 months postoperatively. RESULTS The follow-up period ranged from 6 months to 3 years. Although most patients had exotropic drift, this drift was greater in patients with initial esotropia (86.7%) and orthophoria (70.0%) compared to patients with exotropia (26.1%). Motor success was achieved in 29 (60.4%) patients. There was no statistical difference between ocular alignment at 1 week postoperatively and final motor success (P = .782). There was good correlation between ocular alignment at 1 week and 6 months postoperatively (rho = 0.585, P < .001). Age and preoperative deviation were not found to be associated with motor success. CONCLUSIONS The success rate appears to be unaffected by initial ocular alignment, suggesting that deliberate initial overcorrection may be unnecessary. Future studies are warranted to evaluate the long-term stability of this alignment.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D009801 Oculomotor Muscles The muscles that move the eye. Included in this group are the medial rectus, lateral rectus, superior rectus, inferior rectus, inferior oblique, superior oblique, musculus orbitalis, and levator palpebrae superioris. Extraocular Muscles,Extraocular Rectus Muscles,Inferior Oblique Extraocular Muscle,Inferior Oblique Muscles,Levator Palpebrae Superioris,Musculus Orbitalis,Oblique Extraocular Muscles,Oblique Muscle, Inferior,Oblique Muscle, Superior,Oblique Muscles, Extraocular,Rectus Muscles, Extraocular,Superior Oblique Extraocular Muscle,Superior Oblique Muscle,Extraocular Muscle,Extraocular Muscle, Oblique,Extraocular Muscles, Oblique,Extraocular Oblique Muscle,Extraocular Oblique Muscles,Extraocular Rectus Muscle,Inferior Oblique Muscle,Muscle, Oculomotor,Muscles, Oculomotor,Oblique Extraocular Muscle,Oblique Muscle, Extraocular,Oblique Muscles, Inferior,Oblique Muscles, Superior,Oculomotor Muscle,Rectus Muscle, Extraocular,Superior Oblique Muscles
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003867 Depth Perception Perception of three-dimensionality. Stereopsis,Stereoscopic Vision,Depth Perceptions,Perception, Depth,Perceptions, Depth,Stereopses,Stereoscopic Visions,Vision, Stereoscopic,Visions, Stereoscopic
D005099 Exotropia A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction. Exophoria,Strabismus, Divergent,Alternating Exotropia,Divergent Strabismus,Exodeviation,Monocular Exotropia,Primary Exotropia,Secondary Exotropia,Exodeviations,Exotropia, Alternating,Exotropia, Monocular,Exotropia, Primary,Exotropia, Secondary
D005133 Eye Movements Voluntary or reflex-controlled movements of the eye. Eye Movement,Movement, Eye,Movements, Eye
D005260 Female Females

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