Early postoperative alignment as a predictor of 6-month alignment after intermittent exotropia surgery

The angle of postoperative deviation changes over time in patients undergoing surgery for intermittent exotropia. The aim of the current study was to assess the relationship between the motor alignment at 1 week and 6 months after exotropia surgery.

The records of 81 patients who underwent surgery for intermittent exotropia from 2002 to 2012 at Imam Hussein Medical Center and had at least 6 months of postoperative follow-up were retrospectively reviewed. Each patient underwent complete eye examination and had surgery for orthophoria. Patients were divided into three groups according to their 1-week postoperative alignment (undercorrection [exotropia > 10 prism diopters (PD)], orthophoria [exotropia ≤ 10 PD and esotropia ≤ 5 PD], and overcorrection [esotropia > 5 PD]).

The postoperative success rates for 1 week and 6 months were 75.3% and 76.5% respectively. Of 61 orthophoric, 13 undercorrected, and 7 overcorrected patients at 1 week postoperatively, 51 (83.6%), 7 (53.8%), and 2 (28.6%) patients, respectively, preserved their initial alignment at 6 months (P = .024 for orthophoria). The type of surgery had no effect on the results at 6 months. Reoperation was needed in 10 (12.3%) of our patients at the 6-month follow-up (7 undercorrected and 3 orthophoric patients).

Early postoperative alignment of intermittent exotropia at 1 week can be considered a predictor of orthophoria at 6 months, whereas fewer cases in other groups made predicting their alignment at 6 months statistically difficult. Reoperation was needed in 12.3% of cases at the 6-month follow-up.