Related Experiment Video
Updated: Nov 19, 2025
Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
Published on: September 22, 2023
Effect of age on reoperation rate in children undergoing exotropia surgery
Hwan Heo1,2, Scott R Lambert1
1Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, USA.
Insights
Children undergoing exotropia surgery at younger ages face a higher risk of reoperation. This study highlights age as a critical factor influencing outcomes in pediatric strabismus surgery.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Public Health
Background:
- Exotropia surgery in children aims to correct outward turning of the eye.
- Reoperation rates after strabismus surgery can impact long-term outcomes and patient well-being.
- Understanding factors influencing reoperation is crucial for optimizing surgical strategies.
Purpose of the Study:
- To investigate the association between a child's age at the time of initial exotropia surgery and the subsequent need for reoperation.
- To identify age-specific risks for reoperation following primary exotropia surgery.
Main Methods:
- A population-based retrospective cohort study utilizing de-identified claims data from 2003-2019.
- Included children ≤12 years undergoing their first exotropia surgery with ≥3 years of continuous enrollment.
- Analyzed reoperation rates across three age groups (0-3, 4-6, 7-12 years) using Cox regression analysis.
Main Results:
- Out of 2015 children, 15.5% required reoperation, most commonly for recurrent exotropia.
- Younger children exhibited a significantly higher hazard ratio for reoperation compared to older children (p < 0.001).
- Children aged 0-3 years had a high hazard ratio (2.82) for reoperation for consecutive esotropia.
Conclusions:
- Younger age at initial exotropia surgery is a significant predictor of higher reoperation rates in children.
- These findings underscore the importance of considering patient age in surgical planning and follow-up for exotropia.
- Age-specific risk stratification may help in managing expectations and tailoring postoperative care.
Purpose:
To determine the effect of age on the reoperation rate in children undergoing exotropia surgery.
Methods:
This was a population-based retrospective cohort study using claims data that included children ≤ 12 years who had undergone exotropia surgery as the first strabismus operation and had ≥ 3 years of continuous enrolment were selected from the Optum de-identified Clinformatics Data Mart Database (2003-2019). Patient age at the first exotropia surgery was grouped into three categories; 0-3, 4-6, and 7-12 years. We assessed the sex, race, age, surgical methods, continuous enrolment period after the first surgery, and the time between the first surgery and reoperation. Cox regression analysis was used to estimate the risk of reoperation at different ages. The hazard ratio of reoperation in children undergoing exotropia surgery according to the age at the first exotropia surgery.
Results:
Among 2015 children, 312 (15.5%) underwent one or more reoperations. A reoperation was more often performed for recurrent exotropia (n = 231) than for consecutive esotropia (n = 81). The time between the first surgery and reoperation was shorter for reoperation for consecutive esotropia (376 days) than for recurrent exotropia (672 days) (p < 0.001). Younger children showed a higher reoperation hazard ratio than older children (p < 0.001). In reoperation for consecutive esotropia, the patients aged 0-3 years showed a high hazard ratio (2.82; 95% CI, 1.59-5.01).
Conclusion:
Children undergoing exotropia surgery at a younger age have a higher reoperation rate than those undergoing surgery at an older age.
