Journal List > J Korean Ophthalmol Soc > v.48(8) > 1007905

Park, Jeon, and Choi: Relationship Between Surgical Result and Alignment on The Day of Surgery in Intermittent Exotropia

Abstract

Purpose

We assessed the relationship between the surgical outcome of intermittent exotropia and initial postoperative alignment by checking it on the first postoperative day or the day of strabismus surgery.

Methods

Seventy-three patients with intermittent exotropia underwent bilateral lateral rectus recession or unilateral medial rectus resection and lateral rectus recession. Thirty-two patients had their postoperative alignment checked on the day of surgery, and forty-one patients were checked on the first postoperative day. Success was defined as sustained alignment six months postoperatively from esotropia 10PD to exotropia 10PD. Overcorrection was defined as esotropia greater than 11PD, and undercorrection was exotropia greater than 11PD. We assessed the relationship between the alignment on the day of surgery or on the first postoperative day and also at six months postoperatively, as well as the success rate according to the initial postoperative alignment.

Results

There was a statistically significant relationship between alignments on the day of surgery or on the first postoperative day and those at six months postoperatively (p<0.001, p<0.001). The deviation on the first postoperative day had a greater correlation coefficient compared to the deviation on the day of the operation (Pearson correlation coefficients.704, and 0.593, respectively). The alignment of overcorrection ranged from 11∼20PD on the day of surgery, and on the first postoperative day it produced a relatively high success rate (p=0.016, p=0.035). There was no statistically significant difference in the success rate between the two types of surgery (p=0.832).

Conclusions

The alignment on the day of surgery showed a high correlation to the outcome on the sixth postoperative month in intermittent exotropia patients. The initial postoperative overcorrection of 11 to 20PD on the day of surgery and on the first postoperative day resulted in the best long-term outcomes.

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Figure 1.
Scattergram comparing the alignments of initial postoperative measurement and those of postoperative 6 months.
jkos-48-1106f1.tif
Figure 2.
Surgical result at 6 months of follow-up according to the angle of deviation on the day of surgery.
jkos-48-1106f2.tif
Figure 3.
Surgical result at 6 months of follow-up according to the angle of deviation at 1st postoperative day.
jkos-48-1106f3.tif
Table 1.
Baseline characteristics
  The Day of Surgery 1st Postoperative Day P value
Age 7.4±3.7 7.7±3.1 0.24
Number 32 41 0.46
Follow up (Months) 10.2±8.1 10.7±9.7 0.16
Preoperative deviation (PD) 27.6±7.8 28.7±6.3 0.21

Mean ± Standard deviation.

P-value: Statistical significance was calculated by Student T-test (P<0.05).

Table 2.
Comparison of success rate according to surgical methods
  Number of patients(%)
  The day of surgery 1st postoperative day
BLR 13 of 17 (76.5) 15 of 20 (75.0)
R&R 11 of 15 (73.3) 17 of 21 (81.0)
P-Value 0.579 0.466

BLR: Bilateral lateral rectus recession.

R&R: Unilateral medial rectus resection and lateral rectus recession.

P-value: Statistical significance was calculated by Fisher's exact test (P <0.05).

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