The Long-Term Effect of Part-Time Occlusion Therapy According to Compliance in Recurrent Intermittent Exotropia

Sang Kyoon Kim; Sung-Tae Yi; Seung-Hyun Kim; Yoonae A. Cho

doi:10.3341/jkos.2009.50.1.135

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Kim, Yi, Kim, and Cho: The Long-Term Effect of Part-Time Occlusion Therapy According to Compliance in Recurrent Intermittent Exotropia

Original Article

J Korean Ophthalmol Soc 2009;50(1):135-138.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.1.135

The Long-Term Effect of Part-Time Occlusion Therapy According to Compliance in Recurrent Intermittent Exotropia

Sang Kyoon Kim, M.D.¹, Sung-Tae Yi, M.D², Seung-Hyun Kim, M.D. PhD¹, Yoonae A. Cho, M.D. PhD¹

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

Department of Ophthalmology, Konkuk University College of Medicine, Seoul, Korea

Address reprint requests to Seung Hyun Kim, MD, PhD Department of Ophthalmology, Ansan Hospital, Korea University College of Medicine #516 Gojan-dong, Ansan-si, Gyunggi-do 425-707, Korea Tel: 82-31-412-5160, Fax: 82-31-414-8930, E-mail: ansaneye@hanmail.net

Received 30 September 2008 Accepted 13 May 2008

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 the reoperation rate and the change of exo-angle according to compliance level of part time occlusion therapy in recurrent intermittent exotropia.

Methods

This retrospective study included 52 patients of recurrent intermittent exotropia who followed up more than 5 years after their first operation. They were ordered part time occlusion therapy for recurrent exotropia. The patients were divided into 4 groups according to the level of compliance of part time occlusion therapy ('excellent', 'good', 'fair', 'poor'). We evaluated the reoperation rate in 5 years after the first operation and the change of exo-angle from the early recurrent time according to compliance levels.

Results

The reoperation rate within 5 years after the first operation of 'excellent' and 'good' compliance groups was lower than that of 'fair' and 'poor' groups (33.3, 26.3, 73.7 and 45.5% respectively) and the degree of exo-angle progression from the early recurrent time of the 'excellent' and 'good' compliance groups was less than that of 'fair' and 'poor' compliance groups, both results of which were statistically significant (p=0.02, 0.03).

Conclusions

Part time occlusion therapy in recurrent intermittent exotropia has good long-term effects of decreasingreoperation rates in patients with a high level of compliance.

Keywords: Intermittent exotropia, Part time occlusion therapy, Recurrent, Reoperation rate

References

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Table 1.

Characteristics of patients (Mean± SD)

Group	Age (yr)^†	Preoperative exo-angle (PD)^‡	Immediate postoperative eso-angle (PD)^‡	Interval between first surgery and recurrence (yr)^†	exo-angle dectected at recurrence (PD)^‡
Excellent (n=3)	4.00±1.00	31.7±2.89	12.3±7.23	1.25±1.52	12.67±1.15
Good (n=19)	6.11±2.05	31.0±5.44	7.47±5.16	1.33±1.20	14.42±3.45
Fair (n=19)	6.95±3.05	30.6±7.28	6.26±9.47	1.08±1.12	15.42±3.31
Poor (n=11)	7.10±2.12	29.3±7.66	7.27±5.39	1.34±1.07	16.18±3.03
p value^∗	0.197	0.898	0.603	0.905	0.283

^∗ One way ANOVA analysis

^† Year

^‡ Prism diopters

Table 2.

Comparison of reoperation rate in 5 years after the first operation

Group	No reoperation	Reoperation
Excellent (n=3)	2 (66.7%)	1 (33.3%)
Good (n=19)	14 (73.7%)	5 (26.3%)
Fair (n=19)	5 (26.3%)	14 (73.7%)
Poor (n=11)	6 (54.5%)	5 (45.5%)
P value^∗	0.02

^∗ Chi-square test.

Table 3.

Comparison of exo-angle at 5 years after first operation and change of exoangle (Mean± SD)

Compliance Groups	Excellent	Good	Fair	Poor	P value
Compliance Groups	Good patching		Poor patching		P value
PD at 5 years after first operation	11.3±10.3	14.9±6.80	21.4±5.34	20.7±3.88	0.00^†
PD at 5 years after first operation	14.4±7.15		21.1±4.80		0.00^‡
Change of exo-angle from first recurrence	-1.33±11.4	0.47±7.34	5.95±4.67	4.55±4.30	0.03^†
Change of exo-angle from first recurrence	0.23±7.67		5.43±6.53		0.00^‡

^∗ Prism diopters

^† One way ANOVA analysis

^‡ Student’s t-test.

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