Journal List > J Korean Ophthalmol Soc > v.56(11) > 1010146

Moon and Choi: Surgical Results of Patients with +3.00 Diopters or More Hyperopia and Exotropia

Abstract

Purpose

To evaluate the surgical result of patients who had intermittent or constant +3.00 diopter (D) or more exotropia and hyperopia.

Methods

Twenty-seven patients who had an operation for +3.00 D or more hyperopia and exotropia were included. The dura-tion of follow-up was 6 months or more after surgery. Age at the initial visit, visual acuity, refractive errors, presence of am-blyopia, reduced rate of hyperopic correction, changes in exodeviated angle after reduction of hyperopic correction, surgical re-sults and postoperative data were analyzed.

Results

The mean age at the initial visit was 5.4 years and at surgery was 7.3 years. The mean degree of hyperopia in the worse eye was 3.86 ± 1.35 D and the better eye 1.31 ± 1.19 D. Fourteen of the 27 patients had amblyopia. The degree of reduced hy-peropia correction was 1.35 ± 1.06 D during the preoperative period. The initial angles of deviation were 26.8 ± 7.7 prism diopters (PD) at distance and 28.2 ± 8.9 PD at near. At postoperative 12 months, 19 of 27 patients (70.4%) achieved deviated angle with-in 10 PD. The cause of surgical failure was recurrence of exotropia. All the surgically failed patients had reduced hyperopic cor-rection of the better eye before surgery. Reduction rate of hyperopic correction in the surgically failed group was significantly higher than in the surgically successful group ( p = 0.004).

Conclusions

There was a high incidence of amblyopia in the patients with +3.00 D or more exotropia and hyperopia before surgery. The cause of surgical failure was the recurrence of exotropia, and the degree of reduced hyperopic correction in the sur-gically failed group was larger than in the surgically successful group.

References

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Table 1.
Basic characteristics of patients (n = 27)
Results p-value
Sex (M:F) 12:15
Age at initial visit (years, range) 5.37 ± 3.40 (1 to 14)
Uncorrected visual acuity (log MAR)
Anisometropia*
Worse eye 0.63 ± 0.27 0.001
Better eye 0.19 ± 0.23
Isometropia 0.48 ± 0.19
Amblyopia (No, %) 14 (52)
Initial cycloplegic refraction (D)
Anisometropia
Worse eye 3.86 ± 1.35 0.000
Better eye 1.31 ± 1.19
Isometropia 3.21 ± 1.67
Spectacle prescription (D)
Anisometropia
Worse eye 3.15 ± 1.25 0.000
Better eye 0.52 ± 0.92
Isometropia 1.55 ± 2.38
Exodeviated angle at first visit (PD)
Distance 26.82 ± 7.65 0.589
Near 28.18 ± 8.94
Duration of treatment before surgery (months, range) 26.48 ± 20.07 (5-76)
Duration of treatment after surgery (months, range) 46.74 ± 33.25 (6-122)
Values are presented as mean ± SD unless otherwise indicated.
D = diopter; PD = prism diopter.
* The condition in which two eyes have unequal refractive power with 1 diopter or more.
Table 2.
Comparison of preoperative and postoperative data between surgically successed group and surgically failed group
Success (n = 19) Failure (n = 8) p-value
Sex (M:F) 7:12 5:3 0.307
Age at initial visit (years) 5.32 5.50 0.938
Duration of treatment after surgery (months, range) 40.26 ± 31.65 62.13 ± 33.85 0.132
Amblyopia at initial visit (No.) 8 4 0.706
Amblyopia before surgery (No.) 5 1 0.633
Initial cycloplegic refraction (D)
Worse eye 3.72 ± 1.55 3.39 ± 1.53 0.658
Better eye 2.11 ± 1.91 2.08 ± 0.96 0.696
Spectacle prescription (D)
Worse eye 2.70 ± 2.05 2.00 ± 1.95 0.333
Better eye 1.16 ± 2.01 0.38 ± 0.69 0.481
Hyperopic correction before surgery (D)
Worse eye 1.38 ± 1.77 1.25 ± 1.81 0.897
Better eye 0.59 ± 1.46 0.00 ± 0.00 0.307
Hyperopic correction after surgery (D)
Worse eye 0.91 ± 1.33 0.28 ± 0.56 0.449
Better eye 0.42 ± 0.90 0.09 ± 0.27 0.585
Exodeviation at initial visit (PD)
Distance 27.65 ± 7.93 24.00 ± 6.52 0.543
Near 28.24 ± 9.51 28.00 ± 7.58 0.940
Exodeviation at surgery (PD)
Distance 26.67 ± 10.57 22.50 ± 4.63 0.397
Near 28.33 ± 10.98 26.25 ± 5.18 0.765
Values are presented as mean ± SD unless otherwise indicated.
D = diopter; PD = prism diopter.
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