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Judy Chen, Daniel Maidana, Inae Jang, Majid Rouhbakhshzaeri, Nathalie F Azar, Cem Mocan; The Value of Surgical Realignment in Restoration of Near Stereoacuity in Pediatric Patients with Exotropia. Invest. Ophthalmol. Vis. Sci. 2019;60(9):240.
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© ARVO (1962-2015); The Authors (2016-present)
Loss or deterioration of stereoacuity is a primary indication for surgical correction in pediatric patients who present with exodeviations. The purpose of this study was to evaluate for improvement of near stereoacuity in children with exotropia (XT) undergoing primary eye muscle surgery.
This was a retrospective study undertaken at a single academic center. The clinical records of pediatric patients 14 years of age or younger with XT who underwent strabismus surgery between 2007 to 2017 were reviewed. All patients had stereoacuity testing at near with the Titmus stereoacuity test (Stereo Optical Company, IL, USA). Pediatric patients who presented with sensory XT were excluded from the study. Clinical parameters collected for analysis included type of exodeviation, as well as preoperative and postoperative 6-month magnitude of misalignment in prism diopters (PD) and absence or presence of stereopsis at near. Chi-square test was used for statistical comparisons.
Thirty-five pediatric patients with XT who had a mean age of 8.0±3.5 years (median 7 years; range 3-14 years) were included in the study. Of these, 25 (71%) had been diagnosed with basic exotropia, four (11%) with divergence excess, two (6%) with convergence insufficiency, two (6%) with consecutive XT, one (3%) with paralytic XT, and one (3%) with restrictive XT. The mean preoperative magnitude of misalignment was 28.8 ± 10.9 PD. Prior to surgical correction, absence of stereoacuity was observed in 13 (37%) patients. At the six-month follow-up visit, absence of stereoacuity was observed in 7 (20%) patients within the same cohort (p < 0.001, chi-square test). The mean magnitude of 6-month postoperative misalignment was -4.37 ± 9.61 PD. Of the six (45.9%) patients who regained near stereoacuity following strabismus surgery, four (66.7%) had basic XT, one (16.7%) had divergence excess, and one (16.7%) had paralytic XT.
Strabismus surgery for XT performed in pediatric subjects is associated with recovery of near stereoacuity in nearly half of those who lack stereoacuity prior to realignment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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