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Talisa E de Carlo, Daniel Maidana, Inae Jang, Majid Rouhbakhshzaeri, Nathalie F Azar, Cem Mocan; Evaluation of Early and Late Anatomic Alignment Rates in Pediatric Patients with Intermittent Type of Exodeviation. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4441.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of the study was to determine the rates of successful anatomic alignment in pediatric patients presenting with intermittent exodeviation (IXT) and to evaluate whether early postoperative surgical alignment is predictive of late anatomic success.
This was a retrospective study of pediatric patients who were diagnosed with IXT and who underwent bilateral lateral rectus muscle recessions. Postoperative alignment measurements were recorded for immediate (0-1 week) and 6-month visits. Successful anatomical outcome was defined as alignment within 8 prism diopters of orthotropia. The success-failure rates of alignment were clustered into 4 categories as (1) early and late success (ES-LS), (2) early success-late failure (ES-LF), (3) early failure and late success (EF-LS), and (4) early and late failure (EF-LF). McNemar’s test for dependent proportions was used for statistical analyses.
Twenty-eight patients (11M/17F) with a mean age of 6.5±3.7 years (range=1.5 to 14 years) were included in the study. At distance, 78.6% of cases were aligned at 1 w and 60.7% were aligned 6 mo after surgery. Of the 22 cases with initial successful alignment at 1 w, 13 (59.1%) had sustained alignment at 6-mo time point. There was not a significant difference between the 6-mo success outcomes for patients who were initially aligned at distance at the 1 w time point (n=22) versus that of the entire cohort (n=28) (p=0.267). Overall, the success-failure outcomes at distance for the entire patient cohort were as follows: ES-LS (13/28, 46.4%), ES-LF (9/28, 32.1%), EF-LS (4/28, 14.3%), and EF-LF (2/28, 7.1%).At near, 85.2% of all cases (n=27) were aligned at 1-w and 66.7% aligned at the 6-mo time point. Of the 23 cases who were initially aligned at near, 15 (65.2%) had sustained successful alignments at the post-op 6-mo time point. The success-failure outcomes at near for all subjects were as follows: ES-LS (15/27, 56%), ES-LF (8/27, 30%), EF-LS (3/27, 11%), and EF-LF (1/27, 4%). There was not a significant difference between the 6-mo success outcomes for patients who were initially aligned at near at the 1 w time point (n=23) versus that of the entire cohort (n=27) (p=0.228).
Successful anatomical alignment at 1 w following BLR is not associated with a higher chance of late successful alignment in pediatric patients with IXT.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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