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Postoperative Esotropia: Initial Overcorrection or Consecutive Esotropia?

Hyeshin Jeon1, Heeyoung Choi1

  • 1Department of Ophthalmology and Medical Research Institute, Pusan National University Hospital, Busan - South Korea.

European Journal of Ophthalmology
|April 22, 2017
PubMed
Summary

Consecutive esotropia after exotropia surgery should be diagnosed if it persists beyond one month. Older age, larger preoperative deviation, and vertical deviations are risk factors for persistent esotropia.

Keywords:
ExotropiaStrabismusStrabismus surgery

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Pediatric Ophthalmology

Background:

  • Postoperative esotropia can occur after intermittent exotropia surgery.
  • Differentiating initial overcorrection from true consecutive esotropia is crucial for management.

Purpose of the Study:

  • To determine the time frame for diagnosing consecutive esotropia.
  • To identify risk factors for persistent postoperative esotropia following intermittent exotropia surgery.

Main Methods:

  • Retrospective case series of 50 patients with postoperative esotropia (≥6 prism diopters) at 1 week post-surgery.
  • Patients managed non-surgically and followed for >6 months.
  • Group allocation based on esotropia resolution at 1 month; risk factors analyzed.

Main Results:

  • Significant resolution of esotropia occurred within 1 month post-surgery for most patients.
  • Patients with persistent esotropia (Group 2) were older with larger preoperative distance deviations.
  • Concurrent vertical deviation was more common in the persistent esotropia group.

Conclusions:

  • Esotropia persisting >1 month post-surgery should be classified as consecutive esotropia.
  • Older age, larger preoperative deviation, and vertical deviations are risk factors for persistent postoperative esodeviations.
  • Increased postoperative monitoring is recommended for high-risk patients.