The success of unilateral surgery for constant and intermittent exotropia and factors affecting it in a large scandinavian case series
(2021) In Journal of Pediatric Ophthalmology and Strabismus 58(1). p.34-41- Abstract
Purpose: To compare the results of surgery for constant and intermittent exotropia, to determine factors affecting surgical success, and to evaluate the effect of horizontal rectus muscle surgery on distance-near incomitance. Methods: In this retrospective study of 291 Scandinavian patients, inclusion criteria were surgery for constant (n = 101) or intermittent (n = 190) exotropia with no vertical deviation, no previous strabismus surgery, and available postoperative follow-up data. Medical records of patients (age: 3 to 85 years) undergoing surgery were reviewed. Surgical success was defined as postoperative esodeviation of less than 5 prism diopters (PD) to exodeviation of 10 PD or less. Results: Surgical success was 70% in constant... (More)
Purpose: To compare the results of surgery for constant and intermittent exotropia, to determine factors affecting surgical success, and to evaluate the effect of horizontal rectus muscle surgery on distance-near incomitance. Methods: In this retrospective study of 291 Scandinavian patients, inclusion criteria were surgery for constant (n = 101) or intermittent (n = 190) exotropia with no vertical deviation, no previous strabismus surgery, and available postoperative follow-up data. Medical records of patients (age: 3 to 85 years) undergoing surgery were reviewed. Surgical success was defined as postoperative esodeviation of less than 5 prism diopters (PD) to exodeviation of 10 PD or less. Results: Surgical success was 70% in constant exotropia and 80% in intermittent exotropia (P > .05). At follow-up 1.5 years after surgery, a significant drift was found in intermittent exotropia (P < .05). Different surgeons, spherical equivalents, anisometropia, amblyopia, gender, and age had no effect on surgical success (P > .05). The surgical success rate increased with decreasing preoperative angle (P < .05). Resection of the medial rectus muscle had a greater effect on the near deviation, whereas recession of the lateral rectus muscle had a greater effect on the distance deviation (P < .05). Conclusions: Surgical success was equally good in constant and intermittent exotropia, but better long-term stability was observed following surgery for constant exotropia. The only factor affecting surgical success was the preoperative deviation, with smaller deviations having a better outcome. A distance-near incomitance may be an important consideration in choosing the magnitude of medial versus lateral rectus muscle surgery.
(Less)
- author
- Thorisdottir, Rannveig Linda LU ; Malmsjö, Malin LU ; Tenland, Kajsa LU ; Blohmé, Jonas LU and Hesgaard, Helena Buch
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Pediatric Ophthalmology and Strabismus
- volume
- 58
- issue
- 1
- pages
- 8 pages
- publisher
- Slack Inc
- external identifiers
-
- pmid:33495796
- scopus:85100461719
- ISSN
- 0191-3913
- DOI
- 10.3928/01913913-20201007-04
- language
- English
- LU publication?
- yes
- id
- bda1d90f-6d41-4a4f-bb2c-9cad82ad8690
- date added to LUP
- 2022-01-12 15:33:16
- date last changed
- 2024-04-20 18:48:13
@article{bda1d90f-6d41-4a4f-bb2c-9cad82ad8690,
abstract = {{<p>Purpose: To compare the results of surgery for constant and intermittent exotropia, to determine factors affecting surgical success, and to evaluate the effect of horizontal rectus muscle surgery on distance-near incomitance. Methods: In this retrospective study of 291 Scandinavian patients, inclusion criteria were surgery for constant (n = 101) or intermittent (n = 190) exotropia with no vertical deviation, no previous strabismus surgery, and available postoperative follow-up data. Medical records of patients (age: 3 to 85 years) undergoing surgery were reviewed. Surgical success was defined as postoperative esodeviation of less than 5 prism diopters (PD) to exodeviation of 10 PD or less. Results: Surgical success was 70% in constant exotropia and 80% in intermittent exotropia (P > .05). At follow-up 1.5 years after surgery, a significant drift was found in intermittent exotropia (P < .05). Different surgeons, spherical equivalents, anisometropia, amblyopia, gender, and age had no effect on surgical success (P > .05). The surgical success rate increased with decreasing preoperative angle (P < .05). Resection of the medial rectus muscle had a greater effect on the near deviation, whereas recession of the lateral rectus muscle had a greater effect on the distance deviation (P < .05). Conclusions: Surgical success was equally good in constant and intermittent exotropia, but better long-term stability was observed following surgery for constant exotropia. The only factor affecting surgical success was the preoperative deviation, with smaller deviations having a better outcome. A distance-near incomitance may be an important consideration in choosing the magnitude of medial versus lateral rectus muscle surgery.</p>}},
author = {{Thorisdottir, Rannveig Linda and Malmsjö, Malin and Tenland, Kajsa and Blohmé, Jonas and Hesgaard, Helena Buch}},
issn = {{0191-3913}},
language = {{eng}},
number = {{1}},
pages = {{34--41}},
publisher = {{Slack Inc}},
series = {{Journal of Pediatric Ophthalmology and Strabismus}},
title = {{The success of unilateral surgery for constant and intermittent exotropia and factors affecting it in a large scandinavian case series}},
url = {{http://dx.doi.org/10.3928/01913913-20201007-04}},
doi = {{10.3928/01913913-20201007-04}},
volume = {{58}},
year = {{2021}},
}