Consecutive Exotropia following Strabismus Surgery

Purpose: To determine the possible predictors of the motor outcome after corrective surgery for acquired comitant esotropia. Methods: The study included 40 patients with acquired comitant esotropia. After evaluation of the visual, sensory, and motor status; cycloplegic refraction; fundus examination; and spectacle prescription, all patients underwent corrective strabismus surgery. A successful motor outcome was defined as 0 to 10 prism diopters of horizontal tropia. Statistical analysis of the results was done using the chi-square tests. Results: At the sixth postoperative month, 90% achieved a successful motor outcome, while 2.5% had a consecutive exotropia >10 prism diopters, and 7.5% had a residual esotropia >10 prism diopters. A statistically significant relationship existed between the motor outcome and the following: preoperative results of the Worth four-dot test at 6 m ( p = .011) and 0.33 m ( p = .009), preoperative distant ( p = .016) and near ( p = .017) angles of esotropia with glasses, postoperative near angles of deviation at 1 week ( p = .005), 1 month ( p < .001), 6 weeks ( p < .001), 3 months ( p = .001), and 6 months ( p < .001) following surgery, postoperative distant angles of deviation at 6 weeks ( p < .001) and 3 months ( p = .03) following surgery, 6 week ( p = .01) and 6 month ( p = .036) postoperative results of the Worth four-dot test at 0.33 m, and the 6-month postoperative sensory outcome ( p = .006). Conclusion: Preoperative and postoperative sensory and motor functions are predictors of the 6-month postoperative motor outcome.

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Strabismus Surgery of Consecutive Exotropia

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1097-5653 ◽

2020 ◽

Vol 237 (04) ◽

pp. 506-509

Author(s):

Lucas Janeschitz-Kriegl ◽

Francoise Roulez ◽

Monika Marina Wipf ◽

Anja Palmowski-Wolfe

Keyword(s):

Strabismus Surgery ◽

Dose Effect ◽

Primary Position ◽

Post Surgery ◽

Initial Surgery ◽

Number Of Patients ◽

Consecutive Exotropia ◽

Angle Of Deviation ◽

The Mean ◽

Cover Test

Abstract Purpose The purpose of this study was to determine the surgical outcome, dose-effect (DE), and degree of binocularity in patients undergoing surgery for consecutive exotropia following initial surgery of esotropia. Patients/Methods Twenty-one patients were identified. We analyzed the mean angle of deviation pre- and postoperatively as measured with the alternate prism cover test, DE, and binocularity. Results All patients had had previous strabismus surgery. The surgery for consecutive exotropia had been performed at a mean age of 35.92 ± 18.26 years. In 19 of these patients, surgery of consecutive exotropia involved at least one previously operated extraocular muscle, and the mean interval to the previous surgery was 25.67 ± 16.14 years. The mean angle of deviation (DE) at distance and in the primary position was − 33.43 ± 12.75 prism diopters (PD) preoperatively, + 0.76 ± 7.91 PD 1 week after surgery, and − 7.24 ± 12.14 PD 3 months after surgery. The mean DE was 3.58 ± 1.53 mm/PD at 1 week and 2.70 ± 1.78 mm/PD at 3 months post-surgery. Postoperatively, 62% patients had a binocularity of at least Bagolini positive, 33% had either a positive TNO or Titmus Test, and 24% were Lang I positive (550″). Conclusion Performing strabismus surgery with consecutive exotropia results in restoration of some binocularity in a large number of patients, even in adults, and should be considered as a possibility. The dose-effect is comparable to conventional surgery of exotropia.

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