Comparison of Clinical Features and Long-term Surgical Outcomes in Infantile Constant and Intermittent Exotropia

Abstract

Constant deviation was associated with the development of recurrence, DVD/IOOA, and poor stereopsis after surgery. Constancy of exotropia is a reliable factor for predicting poor surgical outcomes in infantile exotropia at long-term follow-up.

Extent of Improvement in Binocularity and Stereopsis in Constant Concomitant Horizontal Strabismus After Surgical Management and Its Association With the Postoperative Ocular Alignment

“…Na et al evaluated long-term outcomes in intermittent and constant exotropia after surgical correction and observed that cumulative probability of satisfactory surgical alignment three years after surgery was 92% in intermittent exotropia and 70% in constant exotropia and there was significantly more distance suppression (p=0.029) and poor stereopsis (p=0.002) in constant exotropes even after surgical treatment. 15 We also observed in our study that exotropes had a much higher chance of achieving stereopsis than esotropes. 12 (66.6%) of the 18 exotropes and 5 (41.6%) of the 12 esotropes developed stereopsis and 11 (78.5%) of the 14 satisfactorily aligned exotropes and only 5 (55.5%) of the satisfactorily aligned esotropes developed stereopsis.…”

“…[13][14][15][16][17][18] It has been seen that stereopsis is easier to achieve if the strabismus is intermittent rather than constant. [13][14][15] Most intermittent exotropes attain good binocularity and stereopsis after treatment and many have good binocularity and stereopsis even before treatment due to the lack of amblyopia and the presence of time intervals in which they are orthotropic. The constant exotropes, whereas, have poorer preoperative binocularity and though they have substantial improvement in binocularity postoperatively, it is less than that of the intermittent exotropes.…”

“…Thus, studies indicate that attainment of stereopsis is significantly correlated with three factors. [13][14][15][16][17][18] First, stereopsis is significantly associated with the age of onset of strabismus and the earlier the onset of strabismus, the lesser the chances of attaining stereopsis after appropriate treatment and the later the onset of strabismus, the higher the chances of attaining stereopsis after treatment. [16][17][18] Second, stereopsis is significantly associated with the intermittency or constancy of strabismus with intermittent strabismics having a higher chance of attaining stereopsis than constant strabismics.…”

“…[16][17][18] Second, stereopsis is significantly associated with the intermittency or constancy of strabismus with intermittent strabismics having a higher chance of attaining stereopsis than constant strabismics. [13][14][15] Third, stereopsis is significantly associated with the postoperative alignment of the eyes and the closer the patient is to the orthotropic state after treatment, the higher the chances of the patient developing good stereopsis. 8,19 Hence, as strabismologists, we should focus on achieving orthotropia in these patients.…”

Padi̇şah Portreleri̇nden Osmanli Hanedani Göz Hastaliklarina

“…Erken gelişim döneminde, görme eksenlerinin paralelliğini kaybetmesi (göz kayması), düzeltilmemiş kırma kusurları veya beyne gözden net görüntü gitmesini engelleyen katarakt, kapak düşüklüğü (ptozis) gibi göz patolojileri sonucu ortaya çıkan bozulmuş görsel uyaranlar sonucu gelişir. (Na & Kim, 2016) Ambliyopi açısından bakıldığında ekzotropyalarda daha az ambliyopi görülür. Bunun nedeni olarak alternansın daha sık olması ve her iki gözün benzer oranda kullanılması olduğu düşünülmektedir.…”