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Lee, Lee, and Lee: Comparison of Postoperative Outcomes According to Deviation Angle in Moderate-Angle Intermittent Exotropia of Basic Type
Original Article

J Korean Ophthalmol Soc 2007;54(3):475-478.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2013.54.3.475

Comparison of Postoperative Outcomes According to Deviation Angle in Moderate-Angle Intermittent Exotropia of Basic Type

Jin Cheol Lee, MD1, Young Chun Lee, MD2, Se Youp Lee, MD1,

1Department of Ophthalmology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea

2Department of Ophthalmology, Uijeongbu St Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea

Address reprint requests to Se Youp Lee, MD Department of Ophthalmology, Keimyung University Dongsan Medical Center #56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea Tel: 82-53-250-7720, Fax: 82-53-250-7705, E-mail: lsy3379@dsmc.or.kr

Received 10 October 201128 June 2012       Accepted 6 January 2013

Copyright © 2007 Korean Ophthalmological Society

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

This study was conducted to compare the surgical outcomes and stereoacuities after medial rectus (MR) muscle and lateral rectus (LR) muscle recessions, as deviation angle in 20-30 PD basic intermittent exotropia.

Methods

A total of 72 patients were classified into three groups, according to the deviation angle and measured stereoacuities. Twenty-five patients in Group 1, with a deviation angle of 20 prism diopter (PD), underwent MR resection of 4.0 mm and LR recession of 5.0 mm. Group 2, which consisted of 26 patients with 25 PD, underwent 5.0 mm and 6.0 mm. And 21 patients in Group 3 with 30 PD underwent 5.5 mm and 7.0 mm. The success of surgery was determined by the range of a deviation angle within ±8 PD for both near and distance.

Results

The average age was 7.8 years, 7.2 years, and 8.6 years in Group 1, Group 2, and Group 3, respectively. On the final observation, the success rate of the surgery was 84%, 88%, and 90.4% in Group 1, Group 2, and Group 3, respectively. There was no case of overcorrection. Near stereoacuities was found without significant difference at preoperative with postoperative in Group 1, Group 2, and Group 3, respectively (p = 0.26). Postoperative distance stereoacuities showed significant improvements in Group 1, Group 2, and Group 3 (p = 0.04).

Conclusions

Basic intermittent exotropia, which has deviation angle of 20, 25, 30 PD showed no difference in surgical outcomes, according to the deviation angle. There were improvements in the distance stereoacuities after MR resection and LR recession procedure.

Keywords: Basic intermittent exotropia, MR resection and LR recession, Stereoacuities

References

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Table 1.
Surgical amount according to exodeviation angle at distance
Group Exodeviation angle (PD) Amount (mm) Number of patients
MR Resection LR Recession
1 20 4.0 5.0 25
2 25 5.0 6.0 26
3 30 5.5 7.0 21

PD = prism diopter; MR = medial rectus muscle; LR = lateral rectus muscle.

Table 2.
Comparison of mean age, gender and follow-up period
Group Age (mean ± SD, years) Gender (M/F) F/U period (mean ± SD, months)
1* 7.8 ± 1.3 15/10 16.5 ± 4.2
2† 7.28 ± 1.8 13/13 15.0 ± 3.1
3‡ 8.68 ± 2.1 11/10 17.7 ± 3.5
Mean 8.0 39/33 16.4

F/U = follow-up.

* Patients with intermittent exotropia of 20 PD who underwent MR resection of 4.0 mm and LR recession of 5.0 mm

† Patients with intermittent exotropia of 25 PD who underwent MR resection of 5.0 mm and LR recession of 6.0 mm

‡ Patients with intermittent exotropia of 30 PD who underwent MR resection of 5.5 mm and LR recession of 7.0 mm.

Table 3.
Comparison of exodeviation angle at preoperative and last follow-up
Group Mean exodeviation angle (PD)
Preoperative Last F/U
1* 20.0 6.1 ± 3.9
2†
25.0 2.1 ± 4.1
3‡
30.0 4.2 ± 3.9

PD = prism diopter; F/U = follow-up; Preop. = preoperative.

* Patients with intermittent exotropia of 20 PD who underwent MR resection of 4.0 mm and LR recession of 5.0 mm

† Patients with intermittent exotropia of 25 PD who underwent MR resection of 5.0 mm and LR recession of 6.0 mm

‡ Patients with intermittent exotropia of 30 PD who underwent MR resection of 5.5 mm and LR recession of 7.0 mm.

Table 4.
Comparison of mean stereoacuity at preoperative and last follow-up
Group Mean steroacuity (Sec)
Preop. (near/far) Last F/U (near*/far†)
1‡ 108.3 / 125.0 100.4 / 105.7
2§ 88.0 / 117.0 81.5 / 96.5
3 63.3 / 137.7 60.6 / 109.9

Sec = seconds of arc; F/U = follow-up; Preop. = preoperative.

* Titmus test

† Mentor B-VAT II-SG videoacuity tester

‡ Patients with intermittent exotropia of 20 PD who underwent MR resection of 4.0 mm and LR recession of 5.0 mm

§ Patients with intermittent exotropia of 25 PD who underwent MR resection of 5.0 mm and LR recession of 6.0 mm

Patients with intermittent exotropia of 30 PD who underwent MR resection of 5.5 mm and LR recession of 7.0 mm.

Table 5.
Comparison of undercorrection and success rate
Group Undercorrection rate (%) Success rate (%)
1* 16.0 (4/25) 84.0 (21/25)
2† 12.0 (3/26) 88.0 (23/26)
3‡ 9.6 (2/21) 90.4 (19/21)

* Patients with intermittent exotropia of 20 PD who underwent MR resection of 4.0 mm and LR recession of 5.0 mm

† Patients with intermittent exotropia of 25 PD who underwent MR resection of 5.0 mm and LR recession of 6.0 mm

‡ Patients with intermittent exotropia of 30 PD who underwent MR resection of 5.5 mm and LR recession of 7.0 mm.

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