Journal List > J Korean Ophthalmol Soc > v.52(4) > 1009018

Suh, Cha, Cho, and Kim: Clinical Findings of Constant Exotropia Developed from Intermittent Exotropia

Abstract

Purpose

To investigate clinical characteristics of constant exotropia patients with a previous history of intermittent exotropia.

Methods

Constant exotropia patients (CXT) with a previous history of intermittency, and intermittent exotropia patients (X [T]) who had undergone surgery for exotropia were included in the present study. Patching therapy of the fixating eye was performed for all patients. Surgical results, the effect of patching, lateral incomitancy, and suppression were retrospectively reviewed and compared between the 2 groups.

Results

The number of CXT was 51 and X (T) was 84. The angles of deviation at the initial visit and at surgery were significantly larger in CXT. After 3 months of patching therapy, there was no difference between the 2 groups in the reduction of distant angle of deviation. However, the reduction of near angle of deviation was 0.29 ± 5.44 in CXT and 4.42 ± 6.26 Δ in X (T), which was significantly different (p = 0.04). Lateral incomitancy was observed in 7.8% of CXT and 34.5% of X (T) (p < 0.001). The angles of deviation at the final visit and surgical success rate were not different between the groups. Preoperative suppression at distant was found in 100% of CXT and 88.7% of X (T), and postoperative suppression was in 17.6% and 18.3%, respectively.

Conclusions

The surgical success rate and postoperative suppression were not different between constant exotropia and intermittent exotropia. However, the frequency of lateral incomitancy and the response to the patching therapy was lower in constant exotropia.

References

1. Jampolsky A. Ocular deviations. Int Ophthalmol Clin. 1964; 4:567.
2. von Noorden GK. Binocular Vision and Ocular Motility. 5th ed.St Louis: Mosby;2002. p. 356–76.
3. Flynn JT, Mckenney S, Rosenhouse M. Management of intermittent exotropia. Moore S, Mein J, Stockbridge L, editors. Orthoptics: Past, Present, Future. Chicago: Year Book Medical Publishers;1976. p. 551–7.
4. Suh YW, Kim SH, Lee JY, Cho YA. Conversion of intermittent exotropia types subsequent to part-time occlusion therapy and its sustainability. Graefes Arch Clin Exp Ophthalmol. 2006; 244:705–8.
crossref
5. Freeman RS, Isenberg SJ. The use of part-time occlusion for early onset unilateral exotropia. J Pediatr Ophthalmol Strabismus. 1989; 26:94–6.
crossref
6. Jin YH, Son JH. The effect of occlusion in intermittent exotropia. J Korean Ophthalmol Soc. 1991; 32:307–11.
7. Park JY, Sohn HY, Cho YA. Is the nonsurgical treatment effective on intermittent exotropia in children of school-age? J Korean Ophthalmol Soc. 1995; 36:1561–7.
8. Kim SH, Cho YA. Can we effectively delay surgery for intermittent exotropia in children less than 4 years of age? J Korean Ophthalmol Soc. 1996; 37:1382–8.
9. McDonald RJ. Secondary esotropia. Am Orthopt J. 1970; 20:91–5.
crossref
10. Wu H, Sun J, Xia X, et al. Binocular status after surgery for constant and intermittent exotropia. Am J Ophthalmol. 2006; 142:822–6.
crossref
11. Ball A, Drummond GT, Pearce WG. Unexpected stereoacuity following surgical correction of long-standing horizontal strabismus. Can J Ophthalmol. 1993; 28:217–20.
12. Abroms AD, Mohney BG, Rush DP, et al. Timely surgery in intermittent and constant exotropia for superior sensory outcome. Am J Ophthalmol. 2001; 131:111–6.
crossref
13. Kim S, Yi ST, Cho YA. Postoperative recovery of stereopsis in longstanding adult constant-horizontal strabismus. J Korean Ophthalmol Soc. 2005; 46:1831–6.
14. Hardesty HH, Boynton JR, Keenan JP. Treatment of intermittent exotropia. Arch Ophthalmol. 1978; 96:268–74.
crossref
15. Richard JM, Parks MM. Intermittent exotropia. Surgical results in different age groups. Ophthalmology. 1983; 90:1172–7.
16. Repka MX, Arnoldi KA. Lateral incomitance in exotropia: fact or artifact? J Pediatr Ophthalmol Strabismus. 1991; 28:125–8.

Table 1.
Characteristics of patients
  Constant XT Intermittent XT p-value
Age at surgery (mean ± SD, yr) 11.8 ± 4.2 8.7 ± 2.4 0.172
Gender (male: female) 25:26 37:47 0.597
Postoperative follow-up period (mon) 33.5 ± 26.7 35.9 ± 23.7 0.946
Total 51 84  

XT = exotropia.

Table 2.
Comparison of exo-angle (mean ± SD)
  Constant XT Intermittent XT p-value
Exo-angle at first visit (Δ) Distant 42.8 ± 13.9 27.8 ± 6.8 <0.001
Near 43.5 ± 16.1 25.5 ± 9.0 <0.001
Exo-angle at surgery (Δ) Distant 42.5 ± 12.3 27.5 ± 5.8 <0.001
Near 42.8 ± 25.7 25.7 ± 8.0 <0.001
Exo-angle at final visit (Δ) Distant 3.9 ± 6.8 5.2 ± 6.4 0.266
Near 3.9 ± 5.9 5.4 ± 8.2 0.254

XT = exotropia.

Table 3.
Comparison of surgical results at 6 months after surgery
  Constant XT (%) Intermittent XT (%)
Success 84.3 83.3
Recurrent exodeviation 13.7 14.3
Consecutive esodeviation 2.0 2.4

p = 0.809.

XT = exotropia.

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