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Outcomes of surgery in children with early-onset exotropia
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Insights
Early-onset exotropia surgery shows good motor and sensory outcomes, even for constant deviations. Children with early-onset exotropia can achieve successful binocular vision after surgical intervention.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Early-onset exotropia, a condition present before one year of age, requires careful evaluation.
- Understanding the differences between constant and intermittent exotropia is crucial for treatment planning.
Purpose of the Study:
- To assess the clinical features and surgical results of early-onset exotropia.
- To compare outcomes between constant (XT) and intermittent (X(T)) exotropia at presentation.
Main Methods:
- Retrospective review of 45 exotropia patients operated on between 2008 and 2011.
- Analysis of clinical characteristics and surgical outcomes.
- Comparison of outcomes between constant and intermittent exotropia groups.
Main Results:
- Mean age at onset was 9.3 months; mean age at surgery was 4.5 years.
- 67% achieved alignment <10 PD; 29% developed bifixation.
- No significant difference in surgical success or binocularity between constant and intermittent exotropia groups.
Conclusions:
- Surgical outcomes for early-onset exotropia are favorable, including for constant deviations.
- Good motor and sensory results, including binocularity, can be achieved with surgery.
- Early intervention for exotropia can lead to positive visual outcomes.
Objective:
To evaluate the clinical characteristics and surgical outcomes of early-onset exotropia and to compare differences between constant and intermittent exotropia at presentation.
Methods:
The medical records of 45 exotropia patients with a reported onset before 1 year of age who were operated on between 2008 and 2011 were reviewed, and the clinical characteristics and surgical outcomes of these patients were analyzed retrospectively. Patients were then divided into two groups according to type of exotropia at presentation: a constant (XT) group and an intermittent (X(T)) group. Clinical features and surgical results of exotropia were then compared between these two groups.
Results:
The mean age of onset of exodeviation in 45 patients was 9.3±3.8 months. Mean age at surgery was 4.5±2.4 years, and the mean postoperative follow-up period was 17.3 months (range, 6-37 months). Of the 45 patients, 67% showed alignment of less than±10 prism diopters (PD) at final visit. Gross stereopsis was achieved in all 34 testable patients, and bifixation developed in 10 patients (29%). Eleven patients were included in XT group and 34 patients in X(T) group. No significant intergroup difference was found between surgical success rates and binocularities.
Conclusion:
Surgical outcomes, both motor and sensory, were not poor in early-onset exotropia patients, even in patients with constant deviation. Good binocular results following surgery can be achieved in children presenting with apparently constant early-onset exotropia.
