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Surgical results of consecutive exotropia. 2013

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

OBJECTIVE To determine the success rates of different surgical procedures and the risk factors of surgical failure among patients with consecutive exotropia. METHODS Forty patients with exotropia were observed at least 6 weeks after their esotropia surgery. Surgical planning was based on the medial rectus muscle function. Lateral rectus weakening in patients with normal medial rectus function, medial rectus strengthening for patients with limited medial rectus function (-1 to -3), and combined procedure occurred when the correction of each type of surgery was less than the amount of deviation. Postoperatively, patients were divided into success (8 prism diopters [PD] or less) or failure (8 PD or greater) groups. The follow-up period was at least 3 months. RESULTS The mean preoperative exotropia was 29 ± 13 PD, which was reduced to 7 ± 7 PD postoperatively (P < .001). Successful results were achieved in 31 patients (77.5%), 17 (81%) in lateral rectus weakening, 10 (83%) in medial rectus strengthening, and 4 (57%) in the combined procedure group. More preoperative exodeviation was observed in the failure group compared to the success group (P = .015).The mean dose response was 2.27 ± 0.92 PD/mm in the lateral rectus weakening, 4.25 ± 2.27 PD/mm in the medial rectus strengthening, and 2.31 ± 0.66 PD/mm in the combined procedure groups. CONCLUSIONS If the choice of surgical planning is based on medial rectus function and the amount of exodeviation, satisfactory alignment would be achieved in the majority of patients with consecutive exotropia. The preoperative amount of exodeviation was the only risk factor of surgical failure in the study.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
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
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
D005260 Female Females
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages

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