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

Park, Hoon; Kim, Won Jae; Kim, Myung Mi

doi:10.3341/kjo.2016.30.1.60

Cited by 19 publications

(12 citation statements)

References 13 publications

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“…Kwon and Kim reported that stabilization of the postoperative angle of deviation was achieved at three years after surgery in patients with IXT 11 . However, there have been a few previous studies where the occurrence of exodrift was prevalent after surgery in IXT 11 , 12 . In our study, the median onset of exodrift period after surgery was 24 months, but ranging from 3 to 48 months.…”

Section: Discussionmentioning

confidence: 97%

Clinical factors affecting the rate of exodrift after surgery in patients with basic intermittent exotropia

Kim

Suh

et al. 2021

Sci Rep

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We investigated the period of postoperative exodrift during follow-up and clinical factors that affect the rate of exodrift after surgery in the patients with intermittent exotropia (IXT). A retrospective review of medical records of patients with exodrift who underwent bilateral rectus recession for IXT was performed. Exodrift was defined as angle of deviation greater than 10 prism diopters (PD) at distance and near. The median survival period of postoperative exodrift was analyzed using Kaplan Meier survival analysis. The patients were divided into two groups according to the median period of postoperative exodrift (early and late group). The weighted Cox’s proportional hazards regression analysis to investigate the risk factors that affect rate of postoperative exodrift was performed. A total of 108 patients was included. The preoperative angle of deviation at distance and near were 30.3 ± 7.2 PD and 29.5 ± 8.6 PD, respectively. The median survival period of postoperative exodrift was 24 months (range, 6–48 months).The angle of deviation at postoperative day 1 in early and late group were − 3.8 ± 5.5 PD (range, − 16–8 PD) and − 7.7 ± 4.6 PD (range, − 16–4 PD) (p < 0.01). Minus value means esodeviation. In regression analysis, the angle of deviation at postoperative day 1 was the significantly related with rate of exodrift (p < 0.01). The median period of exodrift after surgery was 24 months, angle of deviation at postoperative day 1 could affect the rate of exodrift in patients with IXT.

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Section: Discussionmentioning

confidence: 97%

Clinical factors affecting the rate of exodrift after surgery in patients with basic intermittent exotropia

Kim

Suh

et al. 2021

Sci Rep

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“…Considering the natural exodrift after exotropia surgery, it is likely that small angles of esotropia may resolve spontaneously over time [ 3 , 4 ]. Park et al have shown that more than 50% of the total amount of exodrift was observed within the first postoperative year, but no subsequent changes were observed after 3 years [ 21 ]. Couser et al reported that children treated with botulinum toxin injection within 12 months of consecutive esotropia had an excellent outcome; however, the patient with the longest delay of 53 months between the onset of consecutive esotropia and treatment also had an excellent outcome after two injections [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin injection without electromyographic guidance in consecutive esotropia

2020

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Purpose To investigate the efficacy of botulinum toxin injection without electromyographic guidance for the treatment of consecutive esotropia. Methods A retrospective study was performed on 49 subjects with consecutive esotropia who received botulinum toxin injection in the medial rectus muscles without the use of electromyographic guidance. Treatment was considered successful if the final ocular alignment was orthotropic or esodeviation was ≤10 prism diopters (PD) during distant fixation. Results The mean age was 15.2 ± 8.3 years. The mean esodeviation before injection was 21.8 ± 9.1 PD at distance and 21.3 ± 8.3 PD at near. The mean number of injections per patient was 1.3 ± 0.7, and 46 patients (93.9%) received two or fewer injections. At 6 months after the final injection, the mean angle of esodeviation was 7.3 ± 6.0 PD at distance and 7.5 ± 6.6 PD at near (all p<0.001), and 69.4% showed successful alignment. By multivariate analysis, an initial postoperative esodeviation of ≤18 PD at one month after exotropia surgery was considered to be a predictive factor for successful botulinum toxin injection (P = 0.007). Vertical deviation and/or ptosis occurred in 4 patients (8.2%) at two weeks after injection, which all resolved within three months. There was no recurrence of exotropia up to the final follow-up examination. Conclusion Botulinum toxin injection without electromyographic guidance is safe and effective in the treatment of consecutive esotropia without causing recurrent exotropia. Successful botulinum toxin injection is likely in patients with an initial postoperative esodeviation of 18PD or less at one month after exotropia surgery.

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“…Park and Kim [ 7 ] reported drift rates over 12 months of postoperative follow-up; they indicated that drift rate was fastest at postoperative weeks 1–3, and showed the strongest correlation with overall drift rate. Additionally, previous studies [ 8 , 9 ] showed that more than one-half of the total amount of postoperative exodrift occurred during the first postoperative year. Therefore, fast postoperative exodrift would occur relatively early period after the surgical treatment of exotropia.…”

Section: Discussionmentioning

confidence: 99%

The fast exodrift after the first surgical treatment of exotropia and its correlation with surgical outcome of second surgery

Kim

2018

BMC Ophthalmol

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BackgroundTo compare the rate of exodrift after a second surgery for recurrent exotropia, in patients grouped to fast versus slow exodrift after their first surgery. To determine whether there is a correlation with surgical outcome, and to evaluate the factors associated with fast exodrift.MethodsPatients with recurrent intermittent exotropia, who underwent contralateral lateral rectus recession and medial rectus resection as the second surgery and were followed up for 24 months postoperatively between January 1991 and January 2013, were reviewed retrospectively. The patients were divided into two groups according to the rate of exodrift after the first surgery: Group F, patients exhibiting fast exodrift after the first surgery (> 10 prism diopters [PD] before postoperative month 6); and Group S, patients exhibiting slow exodrift after the first surgery (≤10 PD before postoperative month 6). The difference in the clinical course over the 24 months after the second surgery between the two groups and factors associated with fast exodrift were analyzed.ResultsIn total, 106 patients with recurrent exotropia were enrolled in this study. Of these, 68 (64.2%) and 38 (35.8%) patients were included in group F and S, respectively. Group F showed more exodrift compared with groups S over the 24-month postoperative period; however, there was no significant difference in the clinical course between the two groups during that time (p = 0.54, repeated-measure ANOVA). In logistic analysis, immediate postoperative deviation after the first surgery was associated with fast exodrift (p < 0.001).ConclusionAlthough patients with recurrent exotropia had shown fast exodrift after the first surgery, no significant difference in the surgical outcome was observed after the second surgery according to the rate of exodrift after the first surgery.

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

Cited by 19 publications

References 13 publications

Clinical factors affecting the rate of exodrift after surgery in patients with basic intermittent exotropia

Clinical factors affecting the rate of exodrift after surgery in patients with basic intermittent exotropia

Botulinum toxin injection without electromyographic guidance in consecutive esotropia

The fast exodrift after the first surgical treatment of exotropia and its correlation with surgical outcome of second surgery

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