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Surgical Correction for Pediatric Epiblepharon and Trichiasis
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[In what age should we operate on children with primary exotropia? Indications based on own therapeutic results]
Olimpia Nowakowska1, Magdalena Beben, Piotr Loba
1Klinika Chorób Oczu I Katedry Chorób Oczu Uniwersytetu Medycznego w Łodzi. o.m.nowakowscy@neostrada.pl
Insights
Early surgery for primary exotropia in children improves long-term outcomes, particularly for intermittent strabismus. Younger patients experience less postoperative angle drift, leading to better surgical results.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Context:
- Primary exotropia is a common strabismic condition in children.
- Surgical intervention is a primary treatment modality for exotropia.
- Evaluating age-related outcomes in surgical treatment is crucial for pediatric eye care.
Purpose:
- To evaluate the surgical treatment outcomes for primary exotropia in children operated on before 14 years of age.
- To compare the long-term results between two age groups: 2-6 years and 7-14 years.
- To assess the impact of early surgical intervention on postoperative angle drift and functional vision.
Summary:
- A study of 62 children with primary exotropia found no significant difference in immediate postoperative angles between age groups (2-6 vs. 7-14 years).
- Long-term follow-up revealed lower distance angles in younger children, especially those with intermittent strabismus.
- Younger children with intermittent exotropia exhibited reduced postoperative angle drift, indicating superior surgical outcomes compared to older children.
Impact:
- Early surgical correction of primary exotropia, particularly intermittent types, is associated with improved long-term prognosis.
- Children undergoing early surgery demonstrate a trend towards smaller postoperative angle drift.
- Findings support earlier surgical intervention for better outcomes in pediatric exotropia management.
Purpose:
The aim of the study was to evaluate the results of surgical treatment of children with primary exotropia, operated on before 14 years of age.
Material And Methods:
The study included 62 children with primary, constant and intermittent exotropia operated on before 14 years of age. The patients were divided into two age groups. The first one consisted of children 2 to 6 years old (mean 4.75 +/- 1.12)--12 girls and 8 boys, the second group consisted of children 7 to 14 years old (mean 9.3 +/- 2.1)--30 girls and 12 boys. Follow-up period was 3.5 years in group I and 4.5 years in group II. History, visual acuity and refraction were obtained in all cases. Horizontal and vertical angles for distance and near, before and after the surgery was measured as well. The postoperative horizontal angle drift was estimated in both groups and function of binocular vision assessed, before and after the surgery.
Results:
In both age groups we found no statistical difference between mean angle values before and few weeks after the surgery. However in long-term results, angle for distance was lower in younger children, especially in those with intermittent strabismus. The postoperative angle drift was lower in younger group with intermittent strabismus comparing to the older group, so they achieved a better final surgical outcome. The functional results in both age groups did not differ significantly.
Conclusions:
Early surgery on divergent strabismus makes the prognosis better, especially in intermittent strabismus. Children that are operated on early, seem to have smaller postoperative angle drift.
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