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Updated: Feb 18, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Early versus late surgery for infantile exotropia
1Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
Insights
Older age at surgery increases recurrence risk for constant infantile exotropia. However, age did not impact outcomes for intermittent exotropia or overcorrection in this study.
Area of Science:
- Ophthalmology
- Pediatric Surgery
Background:
- Infantile exotropia is a common condition requiring surgical intervention.
- The optimal timing for surgical correction remains a subject of investigation.
Purpose of the Study:
- To investigate the association between age at surgery and postoperative outcomes in infantile exotropia.
Main Methods:
- This retrospective study analyzed 93 children with infantile exotropia who underwent bilateral lateral rectus recession.
- Outcomes were defined as recurrence (>8 prism diopters exodeviation) or overcorrection (>5 prism diopters esodeviation).
- Univariate and multivariate analyses assessed the impact of age at surgery on recurrence and overcorrection.
Main Results:
- A total of 93 children were included, with a mean age at surgery of 3.2 years.
- Recurrence occurred in 20.4% and overcorrection in 3.2% of patients.
- Increased age at surgery was associated with a higher risk of recurrence (OR=1.031 per month), particularly in constant exotropia (OR=1.410).
Conclusions:
- Older age at surgery is a risk factor for recurrence in constant infantile exotropia.
- Age at surgery did not significantly correlate with outcomes in intermittent infantile exotropia or overcorrection.
Purpose:
To determine whether age at surgery influences postoperative outcome in infantile exotropia.
Methods:
This longitudinal, retrospective study included children who underwent bilateral lateral rectus recession between 2004 and 2012 for an exotropia with onset by 12 months of age. Surgical outcomes were considered failures if recurrence with exodeviation of >8Δ or overcorrection with esodeviation of >5Δ developed during postoperative period. Univariate and multivariate analyses were conducted to compare the association of age at surgery with development of recurrence and overcorrection.
Results:
A total of 93 children were included. Mean age at surgery was 3.2 years. At a mean follow-up of 3.6 years, 19 of 93 patients (20.4%) experienced recurrence and 3 (3.2%) had overcorrection. In the multivariate analyses, increased age at surgery was associated with higher risk for recurrence (OR = 1.031 per 1-month; 95% CI, 1.003-1.060). In subgroup analyses, the association was significant only in the constant exotropia group (OR = 1.410; 95% CI, 1.037-1.917) and not in the intermittent exotropia group (OR = 0.995; 95% CI, 0.938-1.056). In both groups, overcorrection was not associated with any factors, including age at surgery.
Conclusions:
Older age at surgery was associated with risk of recurrence in infantile exotropia with constant deviation, but it was not correlated with surgical outcomes for patients with intermittent exotropia in this study.
