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Na and Lee: Consecutive Esotropia after Lateral Rectus Muscle Recession for Intermittent Exotropia
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1318-1323.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1318

Consecutive Esotropia after Lateral Rectus Muscle Recession for Intermittent Exotropia

Kyeong Ik Na, MD, Joo Yeon Lee, MD, PhD

Department of Ophthalmology, Hallym University College of Medicine, Anyang, Korea.

Address reprint requests to Joo Yeon Lee, MD, PhD. Department of Ophthalmology, Hallym University Sacred Heart Hospital, #22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 431-070, Korea. Tel: 82-31-380-3834, Fax: 82-31-380-3837, kimleejy@hallym.or.kr

Received 12 December 2011       Accepted 21 July 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the progress and outcome of consecutive esotropia after surgery for intermittent exotropia.

Methods

The authors investigated the risk factors, changes in the angle of esodeviation and treatment outcome in consecutive esotropia after lateral rectus muscle recession for intermittent exotropia in 196 patients.

Results

Consecutive esotropia occurred in 25 patients (12.8%). The patients underwent more frequent combined muscle surgeries on vertical and oblique muscles (p = 0.001) and had a greater amount of immediate postoperative overcorrection than subjects without consecutive esotropia. There was no significant difference with the incidence of overcorrection greater than 17 PD between the 2 groups with and without consecutive esotropia. There was no difference with the immediate postoperative overcorrection between the 6 cases that required surgery for their consecutive esotropia and the cases that recovered from their consecutive esotropia with conservative treatment. The former showed increasing esodeviation and maximum angle at average postoperative month 29.5. In the latter, esodeviation tended to decrease and showed maximum angle at average postoperative month 4.3. Finally, esotropia disappeared and good stereoacuity was obtained in both cases.

Conclusions

Although subjects with consecutive esotropia had a greater immediate postoperative overcorrection than subjects without consecutive esotropia, the progress and outcome of consecutive esotropia following the initial overcorrection were not predictable. Consecutive esotropia after surgery for intermittent exotropia showed good overall outcome and well-preserved stereoacuity after treatment.

Keywords: Consecutive esotropia, Intermittent exotropia

Figures and Tables

Figure 1
Time of showing the largest angle of esodeviation in consecutive esotropia during the follow-up after surgery for intermittent exotropia.
jkos-53-1318-g001
Figure 2
Changes in angle deviation in consecutive esotropia during the follow-up after surgery for intermittent exotropia. *Average angle of deviation in 17 patients with non-surgical treatment on each follow-up time.
jkos-53-1318-g002
Table 1
Comparison between subjects with consecutive esotropia and without consecutive esotropia
jkos-53-1318-i001

ET = esotropia; Op = operation; XT = exotropia; PD = prism diopters; POD#1 = postoperative day 1.

*Lateral rectus muscle; †Inferior obligue muscle; ‡Bilateral lateral rectus muscle; §Bilateral superior lectus muscle; ∥Left superior rectus muscle.

Table 2
Comparison between surgical treatment group and non-surgical treatment group in consecutive esotropia
jkos-53-1318-i002

Op = operation; XT = exotropia; PD = prism diopters; POD#1 = postoperative day 1; ET = esotropia.

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