Early Surgery before 4 years of Age in Intermittent Exotropia

ABSTRACT

PURPOSE: We performed this study to evaluate the occurrence of consecutive esotropia after early surgery in the patients with intermittent exotropia less than 4 years of age. METHODS: We analyzed the surgical results of 37 patients who underwent surgery before 4 years of age retrospectively. They were followed up at least more than 1 year after surgery. The orthophoria was defined as an exophoria of 0 to 12PD or an esophoria of 0 to 5PD after surgery. The consecutive esotropia was defined as an esodeviation lasting more than 3 months that needed surgical correction due to sensorial deterioration. RESULTS: Preoperative angle of exodeviation at distance ranged from 20PD to 60PD (mean 35.1 +/- 9.2PD). Twenty-seven of 37 patients (75.7%) showed orthophoria after surgery in 1 year follow-up and 20 of 31 patients (64.5%) in 2 years follow-up. Five patients (13.5%) showed recurrence and 4 patients (10.8%) consecutive esotropia. Immediate postoperative overcorrection was 14.1 +/- 8.7PD(0-30) in patients who were orthophoric after postoperative follow-up more than 2 years. The rate of consecutive esotropia was high in patients with an exo-angle of 30PD or more and a large amount of recession of lateral recti more than 7mm. CONCLUSIONS: This study revealed that consecutive esotropia after early surgery for intermittent exotropia less than 4 years of age was noted to the 10.8%.