Clinical Characteristics and Related Factors of Surgical Outcome in Patient who Underwent LR Recession After the age of 10 years

Jin Ku Park; Sung Eun Kyung

doi:10.3341/jkos.2010.51.7.981

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Park and Kyung: Clinical Characteristics and Related Factors of Surgical Outcome in Patient who Underwent LR Recession After the age of 10 years

Original Article

J Korean Ophthalmol Soc 2010;51(7):981-987.

Published online: 31 August 2010

DOI: https://doi.org/10.3341/jkos.2010.51.7.981

Clinical Characteristics and Related Factors of Surgical Outcome in Patient who Underwent LR Recession After the age of 10 years

Jin Ku Park, MD, Sung Eun Kyung, MD, PhD

Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea

Address reprint requests to Sung Eun Kyung, MD, PhD, Department of Ophthalmology, Dankook University Hospital #San 16-5 Anseo-dong, Cheonan 330-714, Korea Tel: 82-41-550-3971, Fax: 82-41-561-0137, E-mail: kseeye@hanmail.net

Received 31 December 2009 Accepted 1 June 2010

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 identify clinical characteristics and preoperative factors that influence the surgical results of an intermittent exotropia patient who underwent lateral rectus recession after the age of 10 years.

Methods

A retrospective study was performed based on the medical records of 45 patients who underwent unilateral lateral rectus recession or bilateral lateral rectus recession for intermittent exotropia after the age of 10 years and who had undergone at least three months of postoperative follow-up. The authors investigated the clinical characteristics and factors associated with surgical success according to gender, age at surgery, fusion ability, preoperative angle of deviation, preoperative difference between near and far angles of deviation, vertical deviation, spherical equivalent of refractive error, Randot stereo test and postoperative angle of deviation at one week, one month, and three months. The postoperative deviation change according to the time between groups who underwent surgery before and after 10 years of age for intermittent exotropia was also compared.

Results

Surgical success was defined as a final deviation of less than 10 prism diopters. Patients without vertical deviation had a better surgical outcome than did patients with vertical deviation (p=0.022). There was no significant difference in the post-operative deviation changes between groups who underwent surgery for intermittent exotropia before 10 years and after 10 years of age.

Conclusions

Among the many preoperative influencing factors, vertical deviation showed a significant difference in post-operative improvement after intermittent exotropia surgery undergone after the age of 10 years. There was no difference in the aspects of surgical success between surgeries for intermittent exotropia before and after the age of 10 years.

Keywords: Intermittent exotropia, Unilateral or Bilateral lateral rectus recession, Influencing factor, Surgical success factor

References

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Figure 1.

Preoperative chief annoying symptoms

Table 1.

Preoperative and postoperative independent var-iable variables on surgery success

Variables
Sex
Age at surgery
Preoperative distance deviation
Difference between near and distance deviation variable
Fusion
Stereo test
Average spherical equivalent
Vertical deviation
Postoperative distance deviation at 1 week

Table 2.

Comparison of success rate according to factors

Factors		No. of patient (%)		P-value
Factors		Success group	Failure group	P-value
Fusion ability	good	16 (88.9)	2 (11.1)
	fair	15 (100)	0 (0)
	poor	9 (69.2)	3 (30.8)	p=0.332
Preoperative angle of deviation (PD^*)	<30	19 (95)	1 (5)
	30∼39	13 (86.7)	2 (13.3)
	>40	8 (80)	2 (20)	p=0.208
Difference of deviation between N^†&F^‡	≤5	31 (88.6)	4 (11.4)
	6∼10	9 (90)	1 (10)	p=0.694
Stereo test (sec of arc)	≤70	29 (90.3)	2 (9.7)
	70<	11 (78.6)	3 (21.4)	p=0.166
Presence of vertical deviation	absent	20 (100)	0 (0)
	present	20 (80)	5 (20)	p=0.043
Angle of deviation (PD^*) at 1 week postoperatively	≤5	29 (96.7)	1 (3.3)
	6∼10	11 (78.6)	3 (21.4)
	≥10	0 (0)	1 (100)	p=0.04

^* PD=prism diopters;

^† N=Near

^‡ F=Far. Chi-square.

Table 3.

Comparison of average angle of deviation at 1 week, 3 months, 6 months after surgery

Angle of deviation (PD^*)	Monocular LR^† recession	Monocular or Binocular LR^† recession	p-value
After 1 week at far	3.40	3.130.	474
After 1 week at near	3.75	3.370.	246
After 3 months at far	5.27	4.200.	532
After 3 months at near	5.90	4.710.	377
After 6 months at far	6.04	5.170.	897
After 6 months at near	6.24	5.080.	744

^* PD=prism diopters

^† LR=lateral rectus. Student t-test.

Table 4.

comparison of average angle of deviation at 1 week, 3 months, 6 months after surgery

Angle of deviation (PD^*)	Monocular LR^† recession before 10 years	Monocular LR^† recession after 10 years	p-value
After 1 week at far	3.40	3.60	0.801
After 1 week at near	3.75	3.50	0.512
After 3 months at far	5.27	4.10	0.629
After 3 months at near	5.90	3.80	0.751
After 6 months at far	6.04	4.67	0.470
After 6 months at near	6.24	4.67	0.876

^* PD=prism diopters

^† LR=lateral rectus. Student t-test.

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