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Different surgical outcomes in infantile exotropia according to onset time
1Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
Insights
Early onset infantile exotropia (≤6 months) is linked to poorer sensory outcomes, including reduced stereoacuity and suppression. However, motor outcomes like recurrence and overcorrection are not significantly affected by age of onset.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Infantile exotropia is a common form of strabismus in children.
- The age of onset may influence the long-term outcomes of surgical correction.
Purpose of the Study:
- To investigate the impact of age of onset on surgical outcomes in infantile exotropia.
- To compare motor and sensory outcomes between early-onset (≤6 months) and later-onset (>6 months) infantile exotropia.
Main Methods:
- Retrospective review of medical records of 134 patients with infantile exotropia who underwent bilateral lateral rectus recession.
- Patients were categorized into two groups based on onset age: ≤6 months (E6 group) and >6 months (L6 group).
- Evaluation of motor outcomes (recurrence, overcorrection) and sensory outcomes (stereoacuity, suppression).
Main Results:
- No significant difference in recurrence or overcorrection rates between the E6 and L6 groups.
- The E6 group showed a higher proportion of patients with reduced stereoacuity (54% vs 25%) and suppression (46% vs 12%) compared to the L6 group.
- Early onset (≤6 months) was significantly associated with reduced stereoacuity and suppression.
Conclusions:
- Age of onset in infantile exotropia does not influence motor outcomes.
- An onset age of ≤6 months is associated with worse sensory prognosis, including reduced stereoacuity and suppression.
- Surgical management should consider the potential for poorer sensory outcomes in early-onset cases.
Purpose:
To determine whether age of onset influences surgical outcomes in infantile exotropia.
Methods:
The medical records of patients at our tertiary care facility who underwent bilateral lateral rectus recession for infantile exotropia during the period 2004-2013 were reviewed retrospectively. Patients were grouped by onset age: 6 months or earlier (E6 group) or later than 6 months (L6 group). Motor outcomes, near stereoacuity, and distance fusional status in both groups were evaluated.
Results:
A total of 134 patients were included: 35 in the E6 group and 99 in the L6 group. At a mean follow-up of 4.6 years, recurrence occurred in 12 (34%) of the E6 group and 38 (38%) of the L6 group (P = 0.496). Overcorrection occurred in 3 (9%) of the E6 group and in 4 (4%) of the L6 group (P = 0.341). In the analysis of 109 patients eligible for sensory examinations, the E6 group demonstrated a higher proportion of patients with reduced stereoacuity of 80 arcsec or worse (54% vs 25% [P = 0.007]) and suppression (46% vs 12% [P < 0.001]) compared with those in the L6 group. In logistic regression analyses, onset of ≤6 months was significantly associated with reduced stereoacuity (OR = 6.42) and suppression (OR = 37.67) but not with recurrence or overcorrection.
Conclusions:
In our study cohort, age of onset ≤6 months was associated with worse sensory prognosis for children with infantile exotropia but not with a difference in motor outcomes.
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