Exotropic drift and ocular alignment after surgical correction for intermittent exotropia.

PURPOSE: To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia. METHODS: Forty-eight patients aged between 1 and 10 years who underwent bilateral lateral rectus recession for intermittent exotropia were retrospectively evaluated. Preoperative and postoperative ocular deviations at 1 week, 1 month, and 6 months were analyzed. Full surgical correction was attempted in all patients. Motor success was defined as ocular deviation within 10 prism diopters of orthophoria at 6 months postoperatively. RESULTS: The follow-up period ranged from 6 months to 3 years. Although most patients had exotropic drift, this drift was greater in patients with initial esotropia (86.7%) and orthophoria (70.0%) compared to patients with exotropia (26.1%). Motor success was achieved in 29 (60.4%) patients. There was no statistical difference between ocular alignment at 1 week postoperatively and final motor success (P = .782). There was good correlation between ocular alignment at 1 week and 6 months postoperatively (rho = 0.585, P < .001). Age and preoperative deviation were not found to be associated with motor success. CONCLUSIONS: The success rate appears to be unaffected by initial ocular alignment, suggesting that deliberate initial overcorrection may be unnecessary. Future studies are warranted to evaluate the long-term stability of this alignment.

Emulsification and inverted hypopyon formation of oxane HD in the anterior chamber.

BACKGROUND: Oxane HD(R) is a "heavier-than-water" silicone oil which has a specific gravity of 1.02 g/cm(3). When dispersed into droplets, one expects them to sink. We report a case of emulsification of Oxane HD in an eye that unexpectedly manifested as an "inverted hypopyon". METHODS: The clinical findings of a 45-year-old man who underwent pars plana vitrectomy and Oxane HD endotamponade for a phakic inferior rhegmatogenous retinal detachment are described. RESULTS: A large silicone oil globule was noted to be floating in the anterior chamber on postoperative day 1. Emulsification of the globule and inverted hypopyon formation were subsequently observed at 2 months postoperatively. CONCLUSIONS: Emulsification and inverted hypopyon formation in the anterior chamber may occur with Oxane HD. One explanation might be that the Oxane HD has separated out into its constituent components of silicone and RMN3, which raises questions as to the basis for its claim to be a heavier-than-water tamponade.