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Related Experiment Videos

Surgical results in large-angle exotropia.

Gerasimos Livir-Rallatos1, Kammi B Gunton, Joseph H Calhoun

  • 1Department of Pediatric Ophthalmology, Wills Eye Hospital, Philadelphia, PA 19107, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|May 9, 2002
PubMed
Summary

Surgical correction of large angle exodeviations in adults achieved alignment in 62% of cases. Bilateral lateral rectus recessions or recess/resect procedures were effective for deviations up to 50 Delta, but less so for larger angles.

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Pediatric Ophthalmology

Background:

  • Large angle exodeviations in adults can present challenges for surgical correction, particularly when bifixation is lacking.
  • Traditional surgical goals focus on achieving fusion, but in adults with large deviations, establishing alignment is often the primary objective.

Purpose of the Study:

  • To evaluate the surgical outcomes of correcting large angle exodeviations in adults.
  • To determine the effectiveness of specific surgical techniques in achieving alignment for these challenging cases.

Main Methods:

  • A retrospective chart review of 63 adult patients with comitant exodeviation greater than 35 prism diopters (Delta) was performed.
  • Patients with specific complicating factors (e.g., large A/V patterns, nystagmus, paralytic strabismus) were excluded.

Related Experiment Videos

  • Postoperative alignment was categorized into undercorrection (>10 Delta exodeviation), successful outcome (<10 Delta deviation or orthotropia), and overcorrection (>10 Delta esotropia).

    • Main Results:

    • Overall, 62% (39 of 63) of patients achieved a successful outcome.
    • Bilateral lateral rectus recessions and recess/resect procedures were successful in 71% of cases with preoperative deviations up to 50 Delta.
    • For deviations exceeding 50 Delta, 2-muscle surgery resulted in a lower success rate (18%), with significant undercorrection observed in 82% of these cases.

    Conclusions:

    • Surgical correction using bilateral lateral rectus recessions or recess/resect procedures is effective for large angle exodeviations up to 50 Delta in adults.
    • For exodeviations greater than 50 Delta, these standard 2-muscle procedures demonstrate limited success, suggesting a need for alternative surgical strategies.