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Hye Shin Jeon, Jae Ho Jung, Hee-Young Choi; Surgical outcomes of exotropia in patients aged under 4 years. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5224.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate surgical outcomes in children with intermittent exotropia who were operated before 4 years old.
Three hundred forty one patients who had been operated for intermittent exotropia were included in this study. All of the patients were followed up for more than 1 year. Pre and post operative angle of deviation, type of surgery, surgical success rate, stereopsis at final follow up and factors related to success were evaluated. Surgical success was defined as binocular deviation was less than 10 prism diopter(PD) at 1 year after surgery.
Patients were divided into two groups whether operated before 48 months (younger group) or after 48 months (older group). Preoperative horizontal deviation was 31.58 +- 8.43 PD in the younger group and 26.41 +- 8.05 PD in the older group which was significantly larger in the younger group.<br /> 36 (61.0%) of 59 patients in younger group achieved surgical success, 1 (1.70%) had overcorrection and 22 (37.3%) had recurrence. In older group, 177 (62.8%) of 282 patients were successfully aligned, 105 (37.2%) had recurrence. Surgical success rate was not significantly different between two groups. (p=0.883, Chi-square test)<br /> Success rate was significantly higher when the primary horizontal deviation is smaller than 35 PD in the younger group (p=0.036, Chi-square test) and initial esotropia was more prominent at 1 week after surgery. (p=0.034, Mann-whitney U test) Success rate was not significantly different whether deviation is below or above 35 PD in the older group.
Comparable surgical outcome was achieved in patients with intermittent exotropia between the younger and older group. Surgical outcome is likely less favorable when horizontal deviation is larger than 35PD in patients under 4 years old.
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