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Updated: Aug 12, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Clinical effect of early surgery in infantile exotropia
1Department of Ophthalmology, Gachon Medical School, Gil Medical Center, Inchon, Korea.
Insights
Early surgery for infantile exotropia before 24 months significantly improves alignment and sensory functions. Intermittent exotropia benefits most from early intervention, enhancing binocularity and stereopsis.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Infantile exotropia is a common form of strabismus in infants.
- The optimal timing for surgical intervention remains a key consideration for functional outcomes.
Purpose of the Study:
- To assess the impact of early surgical intervention on motor and sensory outcomes in infantile exotropia.
- To determine if the timing of surgery influences the development of binocular vision and stereopsis.
Main Methods:
- Retrospective review of 17 patients with infantile exotropia.
- Surgery performed before 24 months of age with over one year follow-up.
- Analysis of horizontal deviation, fusion, gross binocularity, and stereopsis.
Main Results:
- 82% of patients achieved successful alignment (<10 PD) with early surgery.
- Fusion and gross binocularity developed in 7 and 11 patients, respectively.
- Stereopsis (≤200 seconds) was achieved by 7 patients, notably 83% of those with intermittent exotropia.
Conclusions:
- Surgical intervention before 24 months yields high success rates for infantile exotropia alignment.
- Early surgery, especially for intermittent exotropia, promotes better sensory development, including stereopsis.
- The findings support early surgical correction for optimizing visual function in infantile exotropia.
Abstract:
To evaluate the effects of early surgical intervention in infantile exotropia on the motor and sensory functions, we reviewed the records of 17 subjects diagnosed with exotropia before the age of 12 months, receiving surgery before the age of 24 months, with a follow-up period greater than one year, between 1996 and 2000. Of the 17 subjects (6 intermittent, 11 constant), 14 (82%) (6 intermittent, 8 constant) had a final horizontal deviation of <10 PD, with 3 (18%) needing a re-operation. Fusion and gross binocularity were developed in 7 (4 intermittent, 3 constant), and 11 (6 intermittent, 5 constant) subjects, respectively. Seven subjects developed stereopsis of 200 seconds or better, and 5 of the 6 with intermittent exotropia (83%) being involved. In conclusion, over 80% of the successful alignments were obtained with surgery before the age of 24 months in infantile exotropia, which was similar to previous studies. Furthermore, early surgical intervention, particularly in the intermittent phase, resulted in more effective sensory function.
