Abstract
Purpose :
To evaluate the clinical features and surgical outcomes for the patients with congenital exotropia.
Methods :
A retrospective analysis was performed for 21 patients with congenital exotropia who had at least 50 prism diopters (PD). Patients underwent anterior segment and fundus examination. Teller Card was used to evaluate Children’s visual acuity. Refractive error was examined by the equipment of the VS100--Welch Allyn. Ocular movement and ocular alignment was evaluated pre- and post- operation. The prism and alternate cover test was used to measure the exodeviation angle at both distance and near for those patients who can cooperate very well, and Krimsky test was used for those patients who can not cooperate. All patients underwent bilateral lateral rectus recession with or without inferior oblique muscle transposition, depending on whether combining dissociated vertical deviation (DVD) or not. The follow-up was scheduled regularly at postoperative day 1, 1 week, 1 month, and followed by two month intervals until 18 months.
Results :
There were 13 male and 8 female affected individuals with congenital extropia included in this study, with a mean age of (4.64±2.04) years. The average exodeviation angle was (61.14±8.58) PD (range, 50 to 80 PD) preoperatively. 17 patients underwent bilateral lateral rectus recession, and 4 patients underwent bilateral lateral rectus recession combined with bilateral inferior oblique muscle transposition. The mean surgical dosage was (10.84±1.59) mm for each lateral rectus muclse. All patients did not have abduction deficiency after a large amount of lateral rectus recession. 16 of 21 patients (76.19%) acquired orthophoria at the primary gaze position, 5 of them (23.81%) had recurrent exodeviation at the final visit. 7 patients obtained binocular vision and near stereopsis.
Conclusions :
Large amount of bilateral lateral rectus recession was an effective surgical method for treatment of congenital exotropia.
This is a 2020 ARVO Annual Meeting abstract.