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Professor Malin Malmsjö, MD, PhD. Photo.

Malin Malmsjö

Professor

Professor Malin Malmsjö, MD, PhD. Photo.

The success of unilateral surgery for constant and intermittent exotropia and factors affecting it in a large scandinavian case series

Author

  • Rannveig Linda Thorisdottir
  • Malin Malmsjö
  • Kajsa Tenland
  • Jonas Blohmé
  • Helena Buch Hesgaard

Summary, in English

Purpose: To compare the results of surgery for constant and intermittent exotropia, to determine factors affecting surgical success, and to evaluate the effect of horizontal rectus muscle surgery on distance-near incomitance. Methods: In this retrospective study of 291 Scandinavian patients, inclusion criteria were surgery for constant (n = 101) or intermittent (n = 190) exotropia with no vertical deviation, no previous strabismus surgery, and available postoperative follow-up data. Medical records of patients (age: 3 to 85 years) undergoing surgery were reviewed. Surgical success was defined as postoperative esodeviation of less than 5 prism diopters (PD) to exodeviation of 10 PD or less. Results: Surgical success was 70% in constant exotropia and 80% in intermittent exotropia (P > .05). At follow-up 1.5 years after surgery, a significant drift was found in intermittent exotropia (P < .05). Different surgeons, spherical equivalents, anisometropia, amblyopia, gender, and age had no effect on surgical success (P > .05). The surgical success rate increased with decreasing preoperative angle (P < .05). Resection of the medial rectus muscle had a greater effect on the near deviation, whereas recession of the lateral rectus muscle had a greater effect on the distance deviation (P < .05). Conclusions: Surgical success was equally good in constant and intermittent exotropia, but better long-term stability was observed following surgery for constant exotropia. The only factor affecting surgical success was the preoperative deviation, with smaller deviations having a better outcome. A distance-near incomitance may be an important consideration in choosing the magnitude of medial versus lateral rectus muscle surgery.

Department/s

  • Ophthalmology, Lund

Publishing year

2021

Language

English

Pages

34-41

Publication/Series

Journal of Pediatric Ophthalmology and Strabismus

Volume

58

Issue

1

Document type

Journal article

Publisher

Slack Inc

Topic

  • Surgery

Status

Published

ISBN/ISSN/Other

  • ISSN: 0191-3913