Postoperative minimal overcorrection in the surgical management of intermittent exotropia. 2013

Yoonae A Cho, and Seung-Hyun Kim
Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.

OBJECTIVE To investigate the effect of initial postoperative minimal overcorrection on the result of the surgical management of intermittent exotropia based on long-term follow-up results. METHODS 111 patients who underwent surgery for intermittent exotropia and were followed up for at least 5 years after surgery were retrospectively reviewed. The outcome was judged to be successful when there was 10 prism dioptres (PD) or less of exodeviation and less than 5 PD of esodeviation without any reoperation at the final follow-up visit. We evaluated the success, recurrence, overcorrection rate and the duration of diplopia according to their initial deviation. RESULTS We divided patients into four groups based on their initial deviation: orthophoria or undercorrection (Ortho group, 31 patients), minimally overcorrected at 5 PD or less (MO group, 20 patients), usually overcorrected between 6 PD and 10 PD (UO group, 35 patients), and highly overcorrected at more than 10 PD (HO group, 25 patients). The success rate was 43-60% between the four groups (p=0.52). The recurrence rate was 28-57% (p=0.105), but post hoc analysis showed borderline p values between the Ortho and HO group (p=0.024). No overcorrection was noted in the Ortho and MO groups (p=0.04). The duration of diplopia was 0-2.5 weeks, showing statistically significant difference among groups (p<0.001). CONCLUSIONS The amount of initial postoperative overcorrection may not predict the long-term success rate. However, the MO group showed a lower recurrence rate than the Ortho group and also showed no overcorrection and a shorter duration of postoperative diplopia than the UO and HO groups.

UI MeSH Term Description Entries
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
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
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
D004172 Diplopia A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE. Double Vision,Polyopsia,Diplopia, Cortical,Diplopia, Horizontal,Diplopia, Intermittent,Diplopia, Monocular,Diplopia, Refractive,Diplopia, Unilateral,Diplopia, Vertical,Cortical Diplopia,Cortical Diplopias,Diplopias,Diplopias, Cortical,Diplopias, Horizontal,Diplopias, Intermittent,Diplopias, Monocular,Diplopias, Refractive,Diplopias, Unilateral,Diplopias, Vertical,Horizontal Diplopia,Horizontal Diplopias,Intermittent Diplopia,Intermittent Diplopias,Monocular Diplopia,Monocular Diplopias,Polyopsias,Refractive Diplopia,Refractive Diplopias,Unilateral Diplopia,Unilateral Diplopias,Vertical Diplopia,Vertical Diplopias,Vision, Double
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
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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