Document Detail


Long-term results of the surgical management of intermittent exotropia.
MedLine Citation:
PMID:  20736121     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine long-term surgical success rates (>10 years) for patients with intermittent exotropia and the risk factors for failure of surgery in these patients.
METHODS: An attempt was made to contact all patients who underwent surgical treatment for intermittent exotropia between the years of 1970 to 1998 with a minimum postoperative follow-up of 10 years. Each patient underwent a detailed sensory and motor examination, including measurements of near and distance stereoacuity, cover testing, and ocular rotations. Patients were classified as achieving an excellent, fair, or poor outcome on the basis of motor and sensory outcomes. Risk factor analysis was performed to evaluate associations with a poor outcome and reoperations.
RESULTS: Of 197 patients identified, 50 were reevaluated. When combined motor/sensory criteria for surgical success were used, we found that 38% of patients achieved an excellent outcome, whereas 34% and 28% achieved a fair or poor outcome, respectively. When only the motor criteria were used, we found that 64% had an excellent outcome, whereas the remaining patients achieved either a fair (18%) or a poor (18%) outcome. During the follow-up period, 60% of patients required at least one reoperation. Multivariate risk factor analysis determined that anisometropia (p = 0.03) was associated with a poor outcome, whereas postoperative undercorrection (p = 0.04) and lateral incomitance (p = 0.06) were associated with reoperations.
CONCLUSIONS: Long-term surgical results in intermittent exotropia are less encouraging when sensory status is added to the evaluation. Patients with anisometropia, lateral incomitance, and immediate postoperative undercorrection are at increased risk for poor outcomes and to require reoperations.
Authors:
Stacy L Pineles; Noa Ela-Dalman; Anna G Zvansky; Fei Yu; Arthur L Rosenbaum
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus     Volume:  14     ISSN:  1528-3933     ISO Abbreviation:  J AAPOS     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-25     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9710011     Medline TA:  J AAPOS     Country:  United States    
Other Details:
Languages:  eng     Pagination:  298-304     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.
Affiliation:
Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095-7002, USA. s-pineles@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Depth Perception
Exotropia / physiopathology,  surgery*
Eye Movements / physiology*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Oculomotor Muscles / surgery
Ophthalmologic Surgical Procedures / methods*
Questionnaires
Reoperation
Retrospective Studies
Time Factors
Treatment Outcome
Vision, Binocular
Visual Acuity
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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