Journal List > J Korean Ophthalmol Soc > v.49(7) > 1008019

Ko and Shin: The Clinical Features of Patients with Early Recurrence and with Orthophoria After Intermittent Exotropia Surgery

Abstract

Purpose

To analyze the clinical features of patients with exodeviation of more than 15 prism diopters (PDs) within one month and with orthophoria over three years after surgical correction of intermittent exotropia.

Methods

The early recurrence group consisted of patients with a final distance and near exodeviation more than 15PDs within one month after surgical correction of intermittent exotropia. The surgical success group was defined as patients with orthophoria over three years after surgical correction of intermittent exotropia. Sex, age at onset and surgery, office control status, refraction status, A-V pattern, preoperative and postoperative angles of ocular deviation, binocular sensory status, and the presence of diplopia on postoperative one day were retrospectively investigated and compared between these two groups.

Results

Out of a total of 68 patients, early recurrence occurred in 33 patients, and success was achieved in 35 patients. Factors including sex, age at onset and surgery, office control status, and diplopia on postoperative one day did not differ between the two groups. Preoperative near-angles of ocular deviation, A-V pattern of strabismus, preoperative stereopsis, and the range of postoperative overcorrection contributed to early recurrence.

Conclusions

Factors related to early recurrence were larger preoperative near-angles of ocular deviation, presence of A-V pattern, poor preoperative stereopsis, and a smaller amount of overcorrection on postoperative day 1.

References

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Table 1.
Characteristics of early recurrence group and success group
Early recurrence group Success group P-value
Sex (M/F) 15/18 18/17 0.622
Ageop (year) 7.55±2.16 6.74±1.96 0.114
Ageonset (year) 4.24±1.75 4.14±2.06 0.831
Spherical equivalent (D) -0.063 -1.18 0.189
Mean astigmatism (D) -0.56 -0.71 0.496
Deviation angle (∆) N 33.8 30.3 0.044
F 29.8 26.3 0.052

M=male; F=female; D=diopter; N=near; F=far.

Table 2.
Comparison of A-V pattern between early recurrence group and success group
Early recurrence group (n) Success group (n) P-value
A-V pattern presence 11 2 0.026
absence 22 33

n=the number of patients.

Table 3.
Comparison of the status of office-control between early recurrence group and success group
E Early recurrence group (n) Success group (n) P-value
The status of office-control (near/far) good/fair 2 3
good/poor 4 1 0.480
fair/poor 13 17
poor/poor 14 14

n=the number of patients.

Table 4.
Comparison of stereopsis between early recurrence group and success group
Early recurrence group (n) Success group (n) P-value
Stereopsis ≤ 100 (sec of arc) 8 17 0.038
Stereopsis >100 (sec of arc) 25 18 0.038

n=the number of patients.

Table 5.
Comparison of postoperative deviation between early recurrence group and success group
Early recurrence group Success group P-value
POD 1 day Near 3.6E 9.1E 0.001
Far 1.1E 6.9E 0.001
POD 1 week Near 3.7X 2.6E 0.001
Far 4.1X 3.7E 0.001
POD 1 month Near 12.2X 2.2X 0.001
Far 16.3X 2.6X 0.001

POD=postoperative day; E=esodeviation; X=exodeviation.

Table 6.
Comparison of stereopsis between early recurrence group and success group at postoperative 1 week and 1 month
Early recurrence group (n) Success group (n)
Stereopsis ≤ 100 (sec of arc) 13 16
at postoperative 1 week > 100 (sec of arc) 20 19
Stereopsis ≤ 100 (sec of arc) 10 17
at postoperative 1 month > 100 (sec of arc) 23 18

n=the number of patients.

Table 7.
Comparison of diplopia at postoperative 1 day between early recurrence group and success group
Early recurrence group (n) Success Group (n) P-value
Diplopia Yes 20 26 0.228
No 13 9 0.228

n=the number of patients.

Table 8.
Distribution of deviation at postoperative 1 day
Early recurrence group (n) Success group (n)
Exodeviation
0-10PD 7 2
Esodeviation
0-5PD 10 6
-10PD 14 11
-15PD 1 11
-20PD 1 3
-25PD 0 2

n=the number of patients.

Table 9.
Comparison of variables between early recurrence group and success group with showing less than 10PD esodeviation at postoperative 1 day
Early recurrence group (n) Success group (n) P-value
A-V pattern 6 2 0.032
preoperative worth 4 dot Suppression 24 6 0.002
NRC 0 11

n=the number of patients.

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