Consecutive Exotropia After Bilateral Medial Rectus Recession for Infantile Esotropia

Hyun Kyung Kim; Hye Jin Chung; Shin Hae Park; Sun Young Shin

doi:10.3341/jkos.2009.50.11.1712

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Kim, Chung, Park, and Shin: Consecutive Exotropia After Bilateral Medial Rectus Recession for Infantile Esotropia

Original Article

J Korean Ophthalmol Soc 2009;50(11):1712-1716.

Published online: 31 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.11.1712

Consecutive Exotropia After Bilateral Medial Rectus Recession for Infantile Esotropia

Hyun Kyung Kim, MD, Hye Jin Chung, MD, Shin Hae Park, MD, Sun Young Shin, MD

¹Department of Ophthalmology and Visual Science, The Catholic University of Korea St. Vincent's Hospital, Suwon, Korea

²Department of Ophthalmology and Visual Science, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea

Address reprint requests to Sun Young Shin, MD, Department of Ophthalmology and Visual Science, The Catholic University of Korea Seoul St. Mary's Hospital #505 Banpo-dong, Seocho-gu, Seoul 137-040, Korea Tel: 82-2-2258-1188, Fax: 82-2-590-7405, E-mail: eyeshin@catholic.ac.kr

Received 6 March 2009 Accepted 21 July 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate associated factors by comparing the patients with consecutive exotropia to the patients with orthophoria after undergoing surgery for infantile esotropia.

Methods

The study consisted of 50 patients who underwent bilateral medial rectus recession and attended follow-ups until eight years of age. The authors retrospectively investigated the clinical characteristics ofage at operation, duration between diagnosis and operation, the spherical equivalent of both eyes, the deviated angle at the first visit and immediately before the operation, the recession amount, and the total follow-up period.

Results

During the mean follow-up period of 78.51±54.70 months, 13 patients (26%) had consecutive exotropia, 27 patients (54%) had orthophoria and 10 patients (20%) had remnant esotropia. As the result of comparing orthophoric patients to consecutive exotropic patients, there were no significant differences in the birth weights, the deviated angles at the first visit and immediately before the operation, the spherical equivalents of both eyes, the ages at operation, the recession amounts, and the durations between diagnosis and operation. However, in consecutive exotropia, inferior oblique muscle overaction was 46.5%, dissociated vertical deviation was 46.5% in orthophoric patients, inferior oblique muscle overaction was 19.24%, and dissociated vertical deviation was 8.7%.

Conclusions

A thorough follow-up is necessary when inferior oblique muscle overaction and dissociated vertical deviation occur after undergoing a bilateral medial rectus operation.

Keywords: Consecutive exotropia, DVD, IOOA

References

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Table 1.

Comparative results of orthophoric and consecutive exotropic groups

	Consecutive exotropia	Postoperative orthophoria	p-value
Esodeviation angle at first visit (Δ)	42.69±17.03	39.80±8.54	0.385
Esodeviation angle just before surgery (Δ)	45.54±20.89	42.73±13.86	0.876
Medial rectus recession amount (mm)	5.54±0.40	5.27±0.93	0.729
Age at operation (Months)	32.30±20.27	26.07±14.43	0.696
Duration between diagnosis and operation (Months)	13.37±15.34	8.79±11.6	0.380
Total follow up period (Months)	85.92±13.80	80.57±12.68	0.170
IOOA^‡	6/13 (46.2%)	5/27 (18.52%)	0.02
DVD^§	6/13 (46.2%)	2/27 (7.4%)	0.02

^*Consecutive exodeviation=more than 10Δ exodeviation after bilateral medial rectus muscle recession

^†Postoperative orthophoria=within 10Δ eso and exodeviation after bilateral medial rectus muscle recession

^‡IOOA=inferior oblique overaction

^§DVD=dissociated vertical deviation.

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