Postoperative changes of intermittent exotropia type as classified by 1-hour monocular occlusion
- Authors
- Bae, Seok Hyun; Lee, Young Bok; Rhiu, Soolienah; Lee, Joo Yeon; Choi, Mi Young; Paik, Hae Jung; Lim, Key Hwan; Choi, Dong Gyu
- Issue Date
- 1-Aug-2018
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.13, no.8
- Journal Title
- PLOS ONE
- Volume
- 13
- Number
- 8
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3490
- DOI
- 10.1371/journal.pone.0200592
- ISSN
- 1932-6203
- Abstract
- Purpose To evaluate postoperative changes of the intermittent exotropia type as classified by 1-hour monocular occlusion test. Design Institutional, retrospective study. Methods We retrospectively reviewed the medical records of 179 patients who had undergone surgery for intermittent exotropia with a postoperative follow-up of 6 months or more. We evaluated the exodeviation obtained before and after 1-hour monocular occlusion preoperatively and again at postoperative 1, 3 and 6 months. Intermittent exotropia was divided into 4 types according to Burian's classification. The main outcome measure was the distribution of intermittent exotropia type based on 1-hour monocular occlusion in both pre- and postoperative periods. Result Of the 179 patients, 152 (84.9%) were assigned preoperatively to the basic type, 14 (7.8%) to the pseudo-divergence excess type, and 13 (7.8%) to the convergence insufficiency type. At postoperative 1, 3, and 6 months, the exotropia-type distribution was shifted predominantly to the basic type (p<0.001, p = 0.004, p = 0.029, respectively). Among the preoperative basic-type patients, 96.9% maintained that type postoperatively. However, only 18.2 and 11.1% of the pseudo-divergence excess and convergence insufficiency types maintained the same type. The proportions of the basic type had increased at postoperative 6 months, from 87.8 to 95.7% for bilateral lateral rectus (BLR) recession, from 73.7 to 92.3% for unilateral recess-resect (R&R), and from 88.0 to 95.0% for unilateral lateral rectus (ULR) recession. Conclusion The type of intermittent exotropia changed mostly to the basic type postoperatively even as classified after 1-hour monocular occlusion. This finding was consistent regardless of the surgical methods (BLR, ULR recession and R&R).
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