Short-Term Changes of Immediate Postoperative Deviation after Lateral Rectus Recession for Intermittent Exotropia

PURPOSE: To assess the prevalence of short-term changes in immediate postoperative deviation, and to evaluate the relationship of these to clinical factors after lateral rectus recession for intermittent exotropia. METHODS: One hundred patients who had lateral rectus recession performed for intermittent exotropia and who had at least 3 months of postoperative follow-up were included in this study. RESULTS: The average angle of esodeviation on postoperative day 1 was 8.2 (-5 ~ +25) delta. The rate of surgical success (or=10delta on postoperative day 1 showed a higher chance of surgical failure due to overcorrection at postoperative 3 months (p=0.002). The preoperative deviating angle, type of exotropia, and combined oblique muscle surgery did not influence the outcome. CONCLUSIONS: An esodeviation of 10 ~ 15delta on postoperative day 1 was related to a good outcome at postoperative 3 months. Less esodeviation and smaller exotropic drift occurred in patients aged 10 years and older, so it is possible that an initial overcorrection of >or=10delta may remain for a long period of time in the older patient group.

Initial overcorrection of 20 delta or more after surgery of exotropia

PURPOSE: In order to know the outcome in patients with initial overcorrection of 20 delta or more after the surgery of exotropia. METHODS: Sixty-eight patients initially overcorrected 20delta or more following surgery for an exotropia were managed with an alternate full time occlusion, echothiopate iodide, or prism glasses for the period of overcorrection. The alternate prism cover test was performed at near and distance during the follow up period. Reoperation was performed if esotropia of 20delta or more persist more than three months postoperatively. RESULTS: Most patients (87%) had a preoperative deviation of 35 delta or less at distance. Forty nine patients (72%) had 10 delta or less within 4 weeks postoperatively at distance and near, and 11 patients (16%) including 7 patients with prism glasses between five to 16 weeks postoperatively. One patient who was lost to follow up was found to be orthophoric 32 months postoperatively, and another patient refused to come to the hospital for having straight eyes. Four patients with consecutive esotropia and one patient for postoperative hypotropia after combined recession of superior rectus needed a reoperation. One remaining patient was managed with an alternate full time occlusion. CONCLUSIONS: Initial overcorrection of 20 delta or more occurred mostly in patients with a preoperative exotropia of 35 delta or less at distance. Most patients had 10 delta or less within 3 to 4 months postoperatively; however, 6% needed a reoperation for consecutive esotropia.