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

Byoung-Woo Ko; Sun-Young Shin

doi:10.3341/jkos.2008.49.7.1108

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

Original Article

Commun Sci Disord 2008;49(7):1108-1113.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.7.1108

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

Byoung-Woo Ko, M.D.¹, Sun-Young Shin, M.D.^2,

Department of Ophthalmology, Hanyang Univerisity College of Medicine, Seoul, Korea

Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Sun-Young Shin, M.D. Department of Ophthalmology, Gangnam St. Mary’s Hospital #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-590-1523, Fax: 82-2-590-2044, E-mail: eyeshin@catholic.ac.kr

Received 10 April 2008 Accepted 17 October 2007

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 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.

Keywords: Early recurrence, Intermittent exotropia

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	0.026

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	0.480
	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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