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Decision for Proper Surgical Amount in Consecutive Esotropia Following Bilateral Lateral Rectus Recession

Authors
Seo, Ji WonPaik, Hae Jung
Issue Date
Jan-2018
Publisher
KOREAN OPHTHALMOLOGICAL SOC
Keywords
Consecutive esotropia; Full correction; Intermittent exotropia; Partial correction
Citation
JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY, v.59, no.1, pp.67 - 72
Journal Title
JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY
Volume
59
Number
1
Start Page
67
End Page
72
URI
https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/4257
DOI
10.3341/jkos.2018.59.1.67
ISSN
0378-6471
Abstract
Purpose: To determine the amount of additional surgery required for patients with consecutive esotropia, who had an esodeviation angle similar to their pre-operative exodeviation angle, following bilateral lateral rectus recession surgery for intermittent exotropia. Methods: The medical records of 29 patients who underwent surgery for intermittent exotropia from 1998 through 2013 were reviewed. These patients had consecutive esotropia with an unchanged postoperative esodeviation angle. Thirteen patients underwent esotropia surgery with the aim of full correction (Group A), while 16 patients underwent esotropia surgery with the aim of partial correction (Group B). The postoperative ocular alignment and stereopsis of both groups were compared. Results: A total of 29 patients were evaluated including 13 patients in Group A and 16 patients in Group B. At the final follow-up visit, at least 24 months post procedure, Group B had a significantly greater success rate than Group A (62.5% vs. 23.1%, p = 0.039). Over-correction rates were higher in Group A than Group B (76.9% vs. 37.5%, p = 0.039). The changes during the follow-up period (6 months to their last follow-up) showed that the over-correction rate had increased from 30.8% to 76.9% in Group A (p = 0.034) and from 12.5% to 37.5% in Group B (p = 0.046). Conclusions: Consecutive esotropia surgery with the aim of partial correction showed favorable motor and sensory outcomes in patients who had a postoperative esodeviation angle similar to that of their pre-operative exodeviation. This strategy may also be helpful in preventing long-term postoperative over-correction in patients presenting with consecutive esotropia.
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