Related Experiment Video
Updated: Jan 1, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
The Relationship of Age and Other Baseline Factors to Outcome of Initial Surgery for Intermittent Exotropia
Michael X Repka1, Danielle L Chandler2, Jonathan M Holmes3
1Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Insights
Younger children (3 to <5 years) undergoing surgery for intermittent exotropia (IXT) had better outcomes than older children (5 to <11 years). Further research is needed to confirm these findings on IXT surgical results.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Strabismus Research
Background:
- Intermittent exotropia (IXT) is a common childhood eye misalignment.
- Surgical outcomes for IXT can vary, and factors influencing success require further investigation.
Purpose of the Study:
- To investigate the association between the age of surgical intervention and the 3-year surgical outcome for intermittent exotropia (IXT).
Main Methods:
- A secondary analysis utilized pooled data from a randomized trial involving 197 children with basic-type IXT.
- Participants aged 3 to <11 years received one of two surgical procedures.
- Outcomes were assessed via masked examinations every 6 months for 3 years, with suboptimal outcome defined by specific criteria.
Main Results:
- Children aged 3 to <5 years had a 28% probability of suboptimal surgical outcome, compared to 50% for those aged 5 to <11 years.
- Younger age at surgery was significantly associated with better outcomes (adjusted hazard ratio = 2.05).
- No significant associations were found between suboptimal outcome and other baseline factors.
Conclusions:
- Surgical outcomes for intermittent exotropia appear to be better in younger children (3 to <5 years).
- Further randomized trials comparing immediate versus delayed surgery are necessary to confirm these findings.
- Age at surgery is a critical factor to consider in managing pediatric IXT.
Purpose:
To determine whether age at surgery is associated with surgical outcome of intermittent exotropia (IXT) at 3 years.
Design:
Secondary analysis of pooled data from a randomized trial.
Methods:
A total of 197 children 3 to <11 years of age with basic-type IXT of 15-40 prism diopters (Δ) were randomly assigned to 1 of 2 surgical procedures for treatment of intermittent exotropia. Masked examinations were conducted every 6 months for 3 years. The primary outcome was suboptimal surgical outcome by 3 years, defined as constant or intermittent exotropia of ≥10 Δ at distance or near by simultaneous prism and cover test (SPCT); constant esotropia of ≥6 Δ at distance or near by SPCT; or decrease in near stereoacuity of ≥2 octaves, at any masked examination; or reoperation without meeting any of these criteria.
Results:
The cumulative probability of a suboptimal surgical outcome by 3 years was 28% (19 of 72) for children 3 to <5 years of age, compared with 50% (57 of 125) for children 5 to <11 years of age (adjusted hazard ratio = 2.05; 95% confidence interval = 1.16 to 3.60). No statistically significant associations were found between suboptimal outcome and other baseline factors (magnitude of deviation, control score, fixation preference, or near stereoacuity) (P values ≥ .20).
Conclusions:
This analysis suggests that in children with IXT, younger age at surgery (3 to <5 years) is associated with better surgical outcomes; however, further evidence from a randomized trial comparing immediate with delayed surgery is needed for confirmation.
More Related Videos
06:19Comparison of Three Clinical Stereoscopic Methods for Measuring Binocular Visual Function During Amblyopic Treatment in Unilateral Amblyopia
Published on: September 27, 2024
09:07Author Spotlight: Advancing Endoscopic Ossiculoplasty – Techniques, Innovations, and Practical Guidance for Clinical Integration
Published on: January 26, 2024