Relationship Between Surgical Result and Alignment on The Day of Surgery in Intermittent Exotropia

PURPOSE: We assessed the relationship between the surgical outcome of intermittent exotropia and initial postoperative alignment by checking it on the first postoperative day or the day of strabismus surgery. METHODS: Seventy-three patients with intermittent exotropia underwent bilateral lateral rectus recession or unilateral medial rectus resection and lateral rectus recession. Thirty-two patients had their postoperative alignment checked on the day of surgery, and forty-one patients were checked on the first postoperative day. Success was defined as sustained alignment six months postoperatively from esotropia 10PD to exotropia 10PD. Overcorrection was defined as esotropia greater than 11PD, and undercorrection was exotropia greater than 11PD. We assessed the relationship between the alignment on the day of surgery or on the first postoperative day and also at six months postoperatively, as well as the success rate according to the initial postoperative alignment. RESULTS: There was a statistically significant relationship between alignments on the day of surgery or on the first postoperative day and those at six months postoperatively (p<0.001, p<0.001). The deviation on the first postoperative day had a greater correlation coefficient compared to the deviation on the day of the operation (Pearson correlation coefficient=0.704, and 0.593, respectively). The alignment of overcorrection ranged from 11~20PD on the day of surgery, and on the first postoperative day it produced a relatively high success rate (p=0.016, p=0.035). There was no statistically significant difference in the success rate between the two types of surgery (p=0.832). CONCLUSIONS: The alignment on the day of surgery showed a high correlation to the outcome on the sixth postoperative month in intermittent exotropia patients. The initial postoperative overcorrection of 11 to 20PD on the day of surgery and on the first postoperative day resulted in the best long-term outcomes.

The Effect of the Synthetic Bone Glass on the Fibrovascularization into Porous Polyethylene Orbital Implant

PURPOSE: To evaluate the effect of the synthetic bone glass particulate (BG) on the fibrovascular ingrowth into porous polyethylene orbital implant (PP). METHODS: Forty eight rabbits were divided into 4 groups according to the surgical techniques and implanted materials. One eye was enucleated one eye and PP was implanted in group 1, was eviscerated and PP was implanted in group 2, was enucleated and BG, containing 30% by weight synthetic bone glass particulate, was implanted in group 3, and was eviscerated and BG was implanted in group 4. All implants of each group were assessed by histologic study at the first, second, fourth, and eighth weeks postoperatively. The area of fibrovascular ingrowth was calculated by histologic examination. RESULTS: There were no statistically significant differences in the fibrovascular ingrowth among these groups. A greater number of vessels per unit area and matured fibrous tissue was found in the more outer zone at longer time after implantation, but there was not statistically significant difference among the four groups. CONCLUSIONS: On the basis of this study, the synthetic bone glass particulate did not significantly increase the rate of fibrovascular ingrowth into porous polyethylene orbital implant in rabbits.