Postoperative Stabilization of the Strabismic Angle in Intermittent Exotropia

Abstract

PurposeTo analyze the postoperative strabismic angle for five years or more and to investigate when the angle stabilized in intermittent exotropia.MethodsWe retrospectively reviewed the clinical records of 89 patients who had undergone surgery for intermittent exotropia. The postoperative strabismic angles measured were analyzed at one-year intervals up to five years postoperatively. We divided them into two groups according to their age at the time of surgery. Group 1 was less than 5 years of age, while Group 2 participants were 5 years of age or older.ResultsFor our 89 total patients, average exo-angles were 7.8 ± 7.26, 7.9 ± 7.51, 9.5 ± 7.05, 10.1 ± 6.87, and 9.4 ± 6.90 prism diopters at one, two, three, four, and five years postoperatively, respectively. Average exo-angles between postoperative year one and year three, as well as between postoperative year two and year three, were statistically significant (p = 0.015, 0.022). However, the angles were not statistically significant between postoperative year three and year four or between years three and five, respectively (p = 0.707, p = 0.948). The stabilization characteristics of the angle were somewhat different according to age group. In Group 1, the average exo-angle in postoperative years one and three were statistically significant (p = 0.016), but the angle in the same period was not statistically significant in Group 2 (p = 0.203).ConclusionsThere was no significant interval change after three years postoperatively in intermittent exotropia, but if the patient's age at surgery was 5 years or higher, no significant change of exo-angle was found following postoperative year one in this study.

The Stabilization of Postoperative Exo-drift in Intermittent Exotropia after Surgical Treatment

“…Therefore, the minimum postoperative follow-up duration to ensure good and stable results is 36 months following surgical treatment. Our finding is consistent with the report of Kwon et al [ 12 ], in which the angles of deviation in intermittent exotropia were analyzed postoperatively for up to 5 years. In the present study, we analyzed the postoperative clinical course of intermittent exotropia for up to 7 years, and demonstrated a longer duration of sustained deviation after stabilization.…”

“…Postoperative exo-drift of intermittent exotropia is common [ 4 , 9 , 10 , 11 , 12 ]. Therefore, intermittent exotropia patients should be followed up for some time after surgical treatment to monitor postoperative exo-drift and recurrence.…”

Can Clinical Measures of Postoperative Binocular Function Predict the Long-Term Stability of Postoperative Alignment in Intermittent Exotropia?

“…According to the data, the baseline stereoacuity seems to be unpredictable of the change of the ocular alignment. Based on 89 patients with a follow-up of 5 years, Kwon et al [37] found that nearly 90% exodrift occurred in the beginning of the two-year period following surgery. It remains unknown whether the regression effect or the nature course should be responsible for the progressive exodrift following surgery.…”

Improvement in Fusion and Stereopsis Following Surgery for Intermittent Exotropia

“…Intermittent exotropia is the most prevalent type of childhood exotropia, [1][2][3][4][5][6] affecting almost 1% of the general population. [7][8][9][10] Previous studies have proposed that patients with intermittent exotropia have good near stereoacuity and deteriorated distance stereoacu-ity, 2,11 whereas others 7,8 deemed that near stereoacuity was significantly poor in intermittent exotropia compared to normal patients preoperatively and postoperatively.…”