Early versus late postoperative ocular alignment following bilateral lateral rectus recession in children with intermittent exotropia

Elhomosany, Sara; Massoud, Tamer; Dwidar, Amgad; Elmassry, Ahmed

doi:10.4103/JCRS.JCRS_10_17

Early versus late postoperative ocular alignment following bilateral lateral rectus recession in children with intermittent exotropia

Authors

Abstract

Purpose
The aim of this study was to determine the relationship between early and late postoperative motor outcomes in pediatric patients operated for intermittent exotropia.
Patients and methods
A prospective interventional study was performed on 50 consecutive pediatric patients with intermittent exotropia. All patients were treated with bilateral lateral rectus recession. Distance alignment was analyzed in all patients before and after surgery at week 1 and 6 months postoperatively. Successful results were defined as ocular alignment with exodeviation (tropia/phoria) equal to or less than 10Δ, or esodeviation (tropia/phoria) equal to or less than 5Δ.
Results
A total of 50 patients, 30 (60%) female and 20 (40%) male, were included in this study with a mean age of 5.27±2.92 (0.8–10) years. Mean preoperative angle of deviation was 33.8±5.63Δ (20–45Δ). Bilateral lateral rectus recession was performed in all patients. Regarding the late outcomes analyzed at 6 months postoperatively, it is reported that 33 (66%) patients had favorable outcomes, 12 (24%) patients were undercorrected, and five (10%) cases were overcorrected. A good late outcome had initial alignment of 4.52±7.43 PD of esotropia, whereas patients with late postoperative undercorrection had an average initial postoperative alignment of −2.36±4.18 PD. The differences in average initial alignments were statistically significant between each of the groups (<0.01). However, the average initial postoperative alignment in the overcorrected group was 7±9.9, which was statistically nonsignificant (=0.655).
Conclusion
Initial postoperative overcorrection (0–9Δ) esotropia is desirable in the treatment of patients with intermittent exotropia; however, longer duration of follow-up is required to emphasize this relationship.

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