The Period of Overcorrection after Surgery According to Age in Pediatric Patients with Intermittent Exotropia

PURPOSE: To investigate the recovery period of overcorrection and related factors after surgery in pediatric patients with basic intermittent exotropia (XT). METHODS: Retrospective chart reviews of the medical records of patients who underwent bilateral lateral rectus recession for basic XT were analyzed. Preoperative age, sex, angle of deviation (prism diopters [PD]), and suppression at distance were measured. Patients were observed every week when the angle of deviation was > 2 PD of overcorrection at postoperative day 1. Recovery of overcorrection was defined as improvement of overcorrection with orthotropia. Patients were divided into two groups according to age: younger (group 1) and older (group 2) than 10 years of age. Success was defined as an angle of deviation between 10 PD of exodeviation and 5 PD of esodeviation at the final visit. RESULTS: A total of 88 patients were included. At postoperative day 1, the angle of deviation at distance was −6.9 ± 2.2 PD, and the near angle of deviation was −6.9 ± 2.4 PD. Esodeviation presented as a minus value. The recovery period of overcorrection was 1.9 ± 3.9 weeks and the success rate was 80.7% (71 patients). The success rates of group 1 and group 2 were not statistically significant (p = 0.51). The recovery period of overcorrection in group 2 (2.7 ± 5.9 weeks) was significantly longer than in group 1 (1.8 ± 3.4 weeks) (p = 0.02). CONCLUSIONS: In pediatric adolescents with basic XT, the surgical success rates did not differ significantly according to age, but recovery of overcorrection after strabismus surgery took longer in patients ≥ 10 years of age.

Short-term effect of unilateral recession-resection procedure for intermittent exotropia with insufficient collection / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect and binocular alignment of unilateral recession-resection(R-R)procedure in patients with insufficient convergence intermittent exotropia(IXT).<p>METHODS: Totally 45 patients with insufficient convergence IXT were operated with unilateral R-R procedure. Binocular alignment was accessed 1d postoperative and 2wk postoperative. Statistical analysis was performed on squint at different time points.<p>RESULTS: All 45 patients with insufficient convergence IXT were operated with unilateral R-R procedure. On the 1st day after surgery, an overcorrection of 8.27±7.17PD at distance and 2.40±8.86PD at near were seen. On the 2wk after surgery. An under correction of 1.18±6.98PD at distance and 4.36±7.83PD at near were seen. Within 2wk after surgery, the average exo-drift at distance was 9.45±6.40PD, and at near was 6.77±7.92PD. There was statistically significant difference between exo-drift at distance and near, and a positive correlation was discovered. The difference of near-distance squint at postoperative(3.18±5.60PD)was significantly lower than that of preoperative(7.65±6.55PD), and there was a positive correlation between them.<p>CONCLUSION: Unilateral R-R procedure is appropriate for patients with insufficient convergence IXT. An appropriate increase of medial rectus strengthening can reduce postoperative near-distance squint difference and does not change the tension of medial rectus and lateral rectus. There was a synchronized exo-drift both at distance and near. The postoperative exo-drift at distance was 10PD and we believe a 10PD overcorrection shortly after operation may be beneficial to the long-term binocular alignment.

Characteristics of Patients Who Are Not Responsive to Alternate Patching for Overcorrected Intermittent Exotropia

PURPOSE: To compare the characteristics of patients with surgically overcorrected intermittent exotropia treated with alternate patching. METHODS: The medical records of 51 patients who underwent bilateral lateral rectus muscle recession for intermittent exotropia and required alternate patching to correct postoperative overcorrection were retrospectively reviewed. Patients with postoperative esodeviation ≥18 prism diopters (PD) were started on alternate patching on postoperative day 1, whereas those with postoperative esodeviation of 10 to 17 PD were started after 2 weeks. Postoperative esodeviation <10 PD was considered as slight intentional overcorrection after exotropia surgery. Patients not responsive to alternate patching treatment were defined as those with postoperative esodeviation ≥10 PD after 3 months of treatment. Sex, family history, age, refractive error, amblyopia, stereopsis, suppression, type of exotropia, surgical method, preoperative and postoperative angle of deviation, and start time of alternate patching were compared. RESULTS: Among 51 patients, 29 patients responded to alternate patching and 22 patients did not respond. Female sex (p = 0.04), larger preoperative exodeviation at distance (p = 0.04), late onset of postoperative maximal esodeviation (p < 0.01), larger postoperative maximal esodeviation at near (p = 0.02), and late initiation of alternate patching (p = 0.01) were associated with patients in the non-responsive group. Although postoperative angle of deviation was similar for 2 weeks, the angle of postoperative esodeviation was significantly larger in the non-responsive group than in the responsive group, beginning at 1 month postoperatively. CONCLUSIONS: Female sex, large preoperative exodeviation, late initiation of alternate patching, and large esodeviation 1-month postoperative predisposed patients to be resistant to alternate patching for postoperative overcorrection.

Long-term Surgical Outcomes of Initial Postoperative Overcorrection in Adults with Intermittent Exotropia

PURPOSE: To evaluate the relationship between initial postoperative overcorrection and long-term surgical success in exotropia patients. METHODS: The medical records of 46 patients who underwent surgery for intermittent exotropia after the age of 18 were enrolled. Enrolled patients also had at least 2 years of postoperative follow-up. Based on the initial postoperative deviation at distance measured by prism and the alternating cover test at 1 week, patients were assigned to one of the following groups: group A included patients who demonstrated any esodeviation, while group B included patients who showed orthophoria to exodeviation of 10 prism diopters. The records were analyzed to determine the preoperative deviation with stereoacuity and postoperative deviations with stereoacuity at the follow-up examinations at the following intervals: 1 week; 1, 3, and 6 months; and 1 and 2 years. A comparison between groups for demographic data and preoperative and postoperative angles of deviation was performed using analysis of variance. RESULTS: Of the 46 patients with intermittent exotropia included in this study, 18 (39%) belonged to group A, while 28 (73%) belonged to group B. The postoperative angle of deviation for distant fixation until 2 years of follow-up showed statistically significant differences in each group (p < 0.003 in all comparisons). The amount of exodrift until 2 years in group A (from −9.7 ± 6.1 to 1.6 ± 3.7) was greater than that in group B (from 2.0 ± 2.7 to 6.8 ± 5.6). The long-term surgical success rate within 2 years of surgery was significantly better in group A than in group B (p = 0.027). The number of patients with intermittent diplopia and the duration of diplopia were greater in group A (n = 8) than in group B (n = 2). CONCLUSIONS: Long-term surgical success was achieved in 89% of patients who were initially overcorrected. Overcorrection of an average of 10 prism diopters at the first postoperative week was found to be associated with a more favorable long-term surgical outcome.

The Surgical Overcorrection of Lenke Type 1 Deformities with Selective Fusion Segments: What Happens to the Coronal Balance?

PURPOSE: The aim of our study is to determine the alterations on coronal balance after overcorrection of Lenke type 1 curve, retrospectively. METHODS: Datas of 34 patients (29 female, 5 male patients; mean age, 16.3±3.3 years; range, 13-24 years) surgically treated for scoliosis between 2004 and 2010 were reviewed, retrospectively. The adolescent idiopathic scoliosis patients with Lenke type 1 curve treated with only posterior pedicle screw and postoperative thoracic curves less than 10° by Cobb method on frontal plane were enrolled in this study. Mean follow-up period was 52.5±29.7 months. RESULTS: The mean amount of the preoperative thoracic curves was measured as 41.2°±6.1° (range, 30°-56°). The mean amount of the early postoperative thoracic curves was measured as 6.5°±1.8° (range, 3°-9°). The mean amount of the thoracic curves was measured as 8.5°±4.6° (range, 3°-22°) during the last follow-up (p=0.01). The mean preoperative coronal balance was measured as 8.5mm(range, 1-30mm). The mean early postoperative coronal balance was measured as 3.5mm(range, 0-36 mm). The mean coronal balance was measured as 5.5mm(range, 0-38mm) during the last follow-up (p>0.05). CONCLUSION: We suggest that Lenke type 1B and 1C should be carefully evaluated and the fusion levels should be accurately selected in order to maintain the correction of coronal balance. We suggest that selective fusion with overcorrection in Lenke type 1A are applied to curves that can be corrected lumbar curve at the preoperative bending radiograph and curves that not have coronal decompensation and >10° distal junctional kyphosis, preoperatively.

Clinical analysis of LASlK treatment resulted in overcorrection in Tibetan Plateau / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To investigate the factors and solutions of Tibetan Plateau excimer laser in situ keratomileusis ( LASlK ) for myopia overcorrection.METHODS: The relevant information, 32 cases ( 58 eyes) in 126 cases (252 eyes) had obvious overcorrection after LASlK were analyzed.RESULTS: Two months after surgery, 32 cases ( 58 eyes) overcorrection (23. 0%), uncorrected visual acuity of 0. 5 ~0. 8, overcorrection range of +1. 50 ~ +2. 25DS, subjective inserts were ≥ 1. 0; Five case ( 7 eyes ) overcorrection 6mo after surgery (2. 8%), uncorrected visual acuity 0. 8~1. 0-2 , overcorrection range is +0. 75 ~+1. 25DS, subjective inserts were≥1. 0. Corneal thickness of overcorrection was 500~563μm, preoperative refraction was -5. 00 ~ -7. 50D, astigmatism -1. 50 ~ -2. 75DC, preoperative best corrected visual acuity ≥1. 0.CONCLUSlON: Overcorrection and long recovery time after LASlK in Tibet, possibly with local factors altitude, temperature, humidity, surgical parameters and situation.

Comparison of Standard and undercorrected surgical methods for treating partially accommodative esotropia / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To evaluate the efficacy of standard and undercorrected surgical methods in patients with partially accommodative esotropia (PAET).·METHODS: Twenty-five patients with PAET and normal accommodative convergence/accommodation ( AC/A )were divided into two groups for alternate surgical plan including standard method (13 patients) and under-corrected method (12 patients) in a randomized fashion.Standard method is based on measured deviation through full hyperopic correction at distant target and was performed by Parks scheme. Undercorrected method criteria is 20% lower than standard. All patients underwent symmetrical bilateral medial rectus recessions (BMR), and all of them were followed for 6 months.·RESULTS: Six months after operation, surgical success (defined as tropia =s 8A at distant and near fixation through full hyperopic correction) was 46% in standard group and 91% in undercorrected group. Overcorrection were observed 54% in standard group and 9% in undercorrected group (P＜0.05). There was no residual esotropia. There was no correlation between surgical success rate or overcorrection rate and age, mean of preoperative spherical equivalent or preoperative eye deviation.·CONCLUSION: Undercorrected BMR surgery has a lower overcorrection rate and higher surgical success rate than standard surgery in patients with PAET and normal AC/A.

Consecutive Esotropia in Intermittent Exotropia Patients with Immediate Postoperative Overcorrection More Than 17 Prism Diopters

PURPOSE: To report the incidence and the factors of consecutive esotropia (ET) in patients with immediate postoperative overcorrection of at least 17 prism diopters (PD) after surgery for intermittent exotropia (X(T)). METHODS: Four-hundred-five patients under the age of 18 were included in this study. They underwent bilateral lateral rectus recession (LROU-rec) or unilateral recession-resection (R&R) for X(T). On postoperative day one, the patients with at least 17 PD overcorrection were classified as group 1 and those with less than 17 PD as group 2. Age, refractive error, type of surgery, lateral incomitancy, and the incidence of consecutive ET were analyzed for each group. RESULTS: Group 1 consisted of 116 patients (28.6%) and group 2 consisted of 289 (71.4%). At the six-month follow-up visit, consecutive ET had developed in 16 patients (13.8%) in group 1, and in five patients (1.7%) in group 2 (p<0.001). The occurrence of consecutive ET was not related to age at the time of surgery (p=0.46 in group 1 ; p=0.54 in group 2), refractive error (p=0.18 in group 1 ; p=0.08 in group 2), or the type of surgery (p=0.69 in group 1 ; p=1.00 in group 2). The incidence in group 1 was 23.8% in patients with lateral incomitancy and 8.1% in patients without lateral incomitancy (p<0.05). In group 2, the incidence was 4.4% in patients with lateral incomitancy and 0.5% in patients without lateral incomitancy (p=0.04). CONCLUSIONS: Consecutive ET developed in 13.8% of patients with immediate overcorrection of at least 17 PD. Lateral incomitancy was the most important risk factor.

Clinical Study for the Undercorrection Factor in Intermittent Exotropia

PURPOSE: The surgical technique for intermittent exotropia ?X(T)? is quite simple. However, in many cases, the condition recurs due to any one of a number of causes, including undercorrection. This study examined the factors associated with undercorrection on X(T) patients. METHODS: The study examined 199 X(T) patients who underwent bilateral recession of the lateral rectus muscle or unilateral recession of the lateral rectus muscle and resection of the medial rectus muscle, and who were followed-up for more than a year. Patients whose near and far distance angles of deviation were 9 prism diopters (PD) or more at one year after surgery were designated as group 1. Those whose PD was 8 or below or who had orthophoria were assigned to group 2. Various factors were compared and analyzed. RESULTS: One day after surgery, group 1 showed an average overcorrection of 1.9 and 4.1 PD at near and far, respectively, and group 2 showed an average overcorrection of 6.3 and 7.6 PD at near and far, respectively. A statistically significant difference was observed between the two groups (p0.05). CONCLUSIONS: Of the many factors that might influence the surgical results of X(T) patients, the angle of deviation during the initial postoperative period is the most important factor.

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.

The Usefulness of Duochrome Test for Prevention of Overcorrection in Refraction Tests of Myopic Children

PURPOSE: This study investigates the usefulness of the duochrome test for the prevention of overcorrection in refraction tests of myopic children. METHODS: This prospective study comprises 44 subjects (88 eyes, aged 6 to 10 years) with simple myopia and best-corrected visual acuity of 20/20. After the manifest refraction (MR) was measured with an autorefractometer (KR-8100, Topcon), the refractive error of the duochrome test (DR) was measured at the end point when targets of red and green appeared equally clear. The cycloplegic refraction (CR) was then measured. A statistical analysis and comparison of MR, DR, and CR were conducted using a paired t-test. With strabismus, amblyopia and astigmatism (>or=0.5D), it was excluded. RESULTS: The mean age of the subjects was 8.7+/-1.70 years (range, 6 to 12 years). Mean refractive errors found by MR, DR, and CR were -1.9D+/-0.89 (range, -0.75 to -4.75D), -1.5D+/-0.83, -1.5D+/-0.85 in the right eye, respectively. Those found by MR, DR, and CR in the left eye were -2.0D+/-0.79 (range, -0.75 to -4.75D), -1.7D+/-0.76, and -1.6D+/-0.77, respectively. Differences in the refractive errors of MR and DR, MR and CR were statistically significant (p=0.000, p=0.000 respectively), but there was no statistically significant difference between the refractive errors of DR and CR.(p=0.102) CONCLUSIONS: We found the duochrome test to be an easy and simple method to prevent overcorrection of myopia.

Recovery Pattern of Overcorrection after Intermittent Exotropia Surgery

PURPOSE: To assess the factors which are related to recovery time from overcorrection that occurred immediately after surgery. METHODS: We reviewed the medical records of intermittent exotropia patients who had undergone bilateral lateral rectus muscle recession from February 2002 to July 2004. Fifty patients who developed overcorrection of less than 20 PD on the immediate postoperative day were included in this study. Age at surgery, sex, refractive power, preoperative deviation angle, Worth 4-dot test, and stereopsis were examined, and we evaluated the correlation between these factors and recovery time. RESULTS: Thirty-six patients (72%) recovered to orthoposition within 4 weeks postoperatively. Significant correlations were found between the recovery time and poor stereopsis (p=0.02), and suppression of the Worth 4-dot test (p=0.01). There was no significant relationship between the recovery time and age at surgery, sex, refractive power, and preoperative deviation angle. CONCLUSIONS: In cases of immediate postoperative overcorrection of less than 20 PD after intermittent exotropia surgery, factors related to delayed recovery were poor stereopsis and suppression of the Worth 4-dot test.

A Case of Holmium: YAG Laser Thermal Keratoplasty to Correct Hyperopia Induced by LASIK

PURPOSE: To report a case of noncontact Ho: YAG laser thermal keratoplasty (LTK) treatment for hyperopia induced by laser in situ keratomilieusis (LASIK). METHODS: Following LASIK in a 32-year-old man with -11.0, consecutive hyperopia of +5.25D was seen at 7 months postoperatively. Ho: YAG LTK was applied to the eye with hyperopia after LASIK, and uncorrected/best-corrected visual acuity (UCVA/BCVA), refraction, central keratometric value were measured at 1day, 2 weeks, 3 months, 5 months, and 15 months after Ho: YAG LTK. RESULTS: UCVA was improved to 0.9, and no clinically significant complication occurred until 5 months after Ho: YAG LTK. Although mild hyperopic regression was detected 15 months postoperatively, the patient was satisfied with result of Ho: YAG LTK. CONCLUSIONS: Noncontact Ho: YAG LTK might be considered as a safe and effective measure in correcting LASIK induced hyperopia. Further evaluation is needed to know long-term stabilities of correcting effect.

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.

Related Factors of Surgical Outcome of Unilateral R and R for Basic Type Intermittent Exotropia in Children

PURPOSE: To study the associated factors with surgical success of intermittent exotropia of basic type in children. METHODS: The medical records of 58 children with intermittent exotropia treated with unilateral recession of lateral rectus muscle and resection of the medial rectus muscle and having at least 6 months of follow-up were reviewed. These surgical results were analyzed to assess the association with preoperative factors including sex, photophobia, stereopsis, vertical deviation, time of surgery and preoperative angle of deviation and early postoperative changes in motor alignment which were documented at 2 days, 1 week and 1 month after the surgery. RESULTS: There was significant difference between the early postoperative overcorrection group and others(P<0.05). The overcorrection of 10-20PD showed higher success rate than the overcorrection of 1-9PD at postoperative 1 week. Any preoperative patients' characteristics were not related to surgical outcome. CONCLUSIONS: Early postoperative overcorrection is associated with the good surgical result and the overcorrection of 10-20PD at 1 week can be the predictive factor of better surgical outcome.

Overcorrected Septums as a Complication of Septoplasty / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Overcorrection is defined as obvious deviation of the septum to the opposite direction after septoplasty and it is not infrequently developed in young patients. We investigated the rate of its incidence, especially in relation to age. MATERIALS AND METHODS: We retrospectively studied 1,124 patients undergoing septoplasty operation for septal deviation between 1994 and 1999. The operations and postoperative observation were performed by a single surgeon. We reviewed the medical records for age, sex, symptoms, combined operations, direction of deviation before and after septoplasty. RESULTS: Out of 1,124 patients, 22 (2.0%) had their septum overcorrected after septoplasty and 21 (95%) complained of nasal obstruction of the newly deviated side. The incidence of overcorrection was 7.3% (16/218) in teens, 1.7% (5/294) in twenties, 0.4% (1/250) in thirties, and 0% in older ages. The incidence in teens and early twenties was 5%. Patients of teenagers revealed significantly higher incidence as compared to other age groups (p<0.05). CONCLUSION: Overcorrected septum as a complication of septoplasty develops at the incidence rate of 5% in patients of teens and early twenties. Authors suggest that the depth of cross-hatching incision on the cartilage should be superficial or half-thickness to avoid overcorrection in young patients. And the possibility of overcorrection or revision septoplasty should be informed preoperatively.

Decompensation in Selective Thoracic Fusion by Segmental Pedicle Screw Fixation in King type II Adolescent Idiopathic Scoliosis (AIS): Causative Factors and its Prevention / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: To find the causative factors which induce decompensation after selective thoracic fusion with segmental pedicle screw fixation in King type II AIS. SUMMARY OF LITERATURE REVIEW: Pedicle screw fixation enabling enhanced correction is increasing in use in idiopathic scoliosis. However, there are few reports on the decompensation after selective thoracic fusion with pedicle screw fixation in King type II AIS. MATERIALS AND METHODS: Thirty-nine King type II AIS patients subjected to selective thoracic fusion with pedicle screw fixation were analyzed after a minimum follow up of 1 year. They were reviewed using standing roentgenograms. Deviation of center of T1 from center sacral line greater than 2 cm was considered decompensation. RESULTS: Among 39 patients, compensation was in 35 while decompensation in 4 postoperatively. There was no significant differences between the two groups in preoperative thoracic or lumbar curve characteristics such as curve magnitude, apical deviation or apical rotation. There was a significant difference in thoracic curve correction and postoperative T-curve magnitude divided by preoperative L-curve respectively(p= 0.001). CONCLUSION: Decompensation with selective thoracic fusion with segmental pedicle screw fixation in King type II AIS was not induced by preoperative L-curve characteristics nor derotation maneuver. The factor of decompensation was overcorrection, i.e. if thoracic curve correction was more than 75% or if the magnitude of postoperative T-curve was 30% less than that of preoperative L-curve, there was a high risk of decompensation.

Clinical Result of 105 Cases Overcorrected Temporally after LASIK: 6 Months follow-up

This study aimed to evaluate the refractive and visual results of the cases temporally overcorrected after laser in situ keratomileusis (LASIK). Among 582 myopic eyes that underwent LASIK using VISX STAR from March 1997 to October 1998, 105 eyes were overcorrected more than one diopter (D) one week after LASIK. 105 eyes were divided into three groups according to their spherical equivalent (SE) at one week: Group l (> or = 3D, 9 eyes), group ll (2-2.9D, 14 eyes), and group lll (1-1.9D, 82 eyes).Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), SE, and complications were studied one day, one week, two months, and six months after LASIK. The mean preoperative SE was -11.17 +/-2.57D in group l,-9.40 +/-2.91D in group lland -8.09 +/-1.92D in group lll. At 6 months, the mean SE was 1.81 +/-1.61D, 0.04 +/-0.43D and -0.37 +/-0.76D in group l, ll and lll, respectively. The mean regression of SE from one day to six months was 1.85D, 2.27D and 1.73D in group l,ll and lll, respectively (p>0.05). The proportion of eyes that lost two or more lines of UCVA after LASIK compared to preoperative BCVA was 33.3% in group l, 10% in group ll, and 9.2% in group lll. There were central island (5 eyes), capsular wrinkling (3 eyes), free cap (1 eye), subepithelal metalic debris (1 eye), epithelial ingrowth (1 eye)as complications in all groups. With these results it might be concluded that hyperopia less than 3D one week after LASIK is temporary and disappears 6 months after surgery without any additional treatment, whereas hyperopia equal or more than 3D one week after LASIK still showed hyperopic refraction even after 6 months. Therefore, these eyes need further evaluation for the correction of hyperopia.

Overcorrection, Undercorrection and Astigmatic Change after Excimer Laser Photorefractive Keratectomy of Myopia

We have studied the overcorrection, undercorrection, astigmatic change and its incidence on time sequence after the excimer laser photorefractive keratectomy, and its relation with the degree of preoperative myopia, sex, and age. The study has been done with 429 eyes which we could assess for 6 months or more after excimer laser photorefractive keratectomy of myopia from July 1993 to march 1997. Overcorrection of more than -1D was common during the early postoperative periods and then gradually decreased with time. Overcorrection has been seen in 261 eyes(60.84%) after 1 month, but only 33 eyes(13.47%) after 1 year, and 13 eyes(11.02%) after 2 years. Undercorrection has been seen in 2 eyes(0.47%) after 1 month, but 25 eyes(10.20%) after 1 year, and 20 eyes(16.95%) after 2 years. Surgically induced astigmatism increased to 0.54+/-0.84D after 10 days and then decreased 0.19+/-0.75D after 12 months. Also, surgical induced astigmatism developed 1.13+/-1.10D in 247 eyes (57.58%) after 1 month, but decreased 0.89+/-0.45D in 107 eyes(43.67%) after 12 months. The occurrence of overcorrection and undercorrection was related to the severity of preoperative myopia(p0.05). The amount of postoperative astigmatism was related to preoperative astigmatism(p0.05).

The influence of fusional divergence on the surgical results in intermittent exotropia

We investigated the influence of fusional divergence on the surgical results in the intermittent exotropia. Among the 56 patients with intermittent exotropia. the angle of deviation was measured during the preoperative period and the postoperative periods. The amplitude of the fusional divergence was measured with the rotary prism after the correction of the angle of deviation with the prism before the surgery. The subjects were devided into 4 groups; group one which returned to orthophoria after the overcorrection of exodeviation; group two - which did not return to orthophoria after the overcorrection of exodeviation; group three - which remained orthophoria after the correction of exodeviation; group four - which showed orthophoria initially but returned to undercorrection. There was not any significant difference between the four groups. We concluded that the influence of fusional divergence on the surgical results for intermittent exotropia was not significant enough. However, further studies should be done with more subjects for better results.