Comparison of the Stability of Postoperative Alignment in Sensory Exotropia: Adjustable Versus Non-Adjustable Surgery

PURPOSE: To compare the success rates and stabilities of postoperative alignment between adjustable and the non-adjustable surgeries in the treatment of sensory exotropia. METHODS: A retrospective analysis was performed on all patients with sensory exotropia who had undergone unilateral lateral rectus recession and medial rectus resection (R&R) between January 1998 and August 2005. Thirty-four patients underwent conventional R&R, and 20 patients underwent R&R with adjustable suture of the lateral rectus. The surgical results between the two groups were analyzed with regard to the preoperative and post-operative deviation angles and the postoperative drift. The postoperative deviation angle was measured on postoperative day 1 as well as at two weeks, three months, six months and the final visit after surgery. RESULTS: There were no statistically significant differences in the mean preoperative and postoperative deviation angles between the two groups. In 30 (88%) patients in the non-adjustable group and 15 (75%) patients in the adjustable group, postoperative deviation was less than 15 prism diopters (PD) at the three month follow-up. There was no significant difference in the mean postoperative drift between the two groups. CONCLUSIONS: Strabismus surgery with adjustable sutures did not show a significantly better result than surgery without adjustable sutures in the treatment of sensory exotropia. Considering the amount of postoperative exodrift in both groups, we postulate that the immediate ocular alignment after surgery for sensory exotropia should be orthophoric or 5-6 PD of esodeviation.

Surgical Results in Basic Exotropia of Moderate Degree

The purpose of this study is to assess the postoperative stability for exotropia by comparing the deviation at postoperative 2 years to those at 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year after surgery in children with basic exotropia of between 25 and 30 prism diopters. They were classified into two groups:one group[n=20]with unilateral lateral rectus recession and medial rectus resection, and another group[n=15] with bilateral lateral rectus recession. There was no difference in age at the time of surgery or preoperative angle of deviation between the two groups. Exodrift occurred according to an increase in follow-up and maximal correlation between postoperative 6 months and 2 years in both groups[r=0.85, r=0.81, respectively, p>0.05]was noted. Success rates at postoperative 2 years were 65%and 60%, respectively[p>0.05]. In conclusion, long-term surgical results for exotropia of moderate degree and basic type could be predicted from angle of deviation at postoperative 6 months, regardless of the type of surgery.