exotropia after strabismus surgery

If you or your child has been diagnosed with strabismus, surgery is an effective way to improve eye alignment. However, it is important to understand that while surgery will correct the eye turn to help your eyes appear aligned, it cannot stimulate the two eyes to work together for clear vision. Exotropia refers to an outward deviation of the eyes. Surgical success and lateral incomitance following three-muscle surgery for large-angle horizontal strabismus. here. The authors concluded that unilateral lateral rectus recession could lead to similar results in 15 to 20 PD exotropia for the first operation or recurrent exotropia. The authors concluded that recession of the medial rectus muscle 13.5 mm from the limbus seemed to be a safe and effective method of treating surgically undercorrected esotropia. Bilateral lateral rectus resection is the most common surgical method for the treatment of residual or recurrent esotropia following bilateral medial rectus recession, while unilateral lateral rectus resection can be appropriate for small-angle residual esotropia of up to 20 PD. More recently, Kim et al[55] compared outcomes following contralateral lateral rectus recession (n=19) and recess-resect procedures (n=20) for treatment of recurrent exotropia of 20-25 PD after unilateral recess-resect surgery. A mixed model was applied to compare the refractive error between the operated and fellow eyes and identify the factors associated with postoperative refractive changes. This is partially due to the difference in the amount of recession. Rajavi et al[10] recently suggested that lateral rectus underaction was found to be risk factors of reoperation and nystagmus might increase the risk of requiring reoperation for residual esotropia[11]. Nucci P, Serafino M, Trivedi RH, Saunders RA. Manual retinoscopic refraction was performed by our senior author (SJK). On the other hand, Trigler et al[8] suggested that preoperative angle of deviation was a prognostic factor for the success of esotropia surgery. Therefore, there was a difference in the duration of surgery between the subgroups according to the type of surgery. Kim HJ, Kim D, Choi DG. Careers, Unable to load your collection due to an error. PMC As a library, NLM provides access to scientific literature. Refractive changes after strabismus surgery in patients with - PLOS Constant exotropia. To determine the preferred eye for fixation, a repeated cover-uncover test was performed for each patient. Effect of resection of lateral rectus muscle in undercorrected esotropia. Suh et al[48] retrospectively analyzed the mean correction amount of per millimeter of medial rectus resection for recurrent exotropia after bilateral lateral rectus recession, the difference in the effects between unilateral and bilateral resection, and the influence of previous lateral rectus recession on the effects of medial rectus resection. Unable to load your collection due to an error, Unable to load your delegates due to an error. In addition, our LRc group showed that the amount of recession was correlated with the magnitude of astigmatism change with borderline significance. [ 4, 7] Surgical management of residual or recurrent esotropia following maximal bilateral medial rectus recession. Large unilateral medial rectus resection has more advantages than bilateral surgery, for instance, the lower rate of overcorrection, decreased surgery and anesthetic time, decreased postoperative discomfort, limitation of the risk of complications to one eye [47]. Data Availability: Data cannot be shared publicly because data contain potentially identifying or sensitive patient information. PLOS ONE promises fair, rigorous peer review, Data curation, Kim SJ, Kwak JJ, Lee CY. Although many studies regarding postoperative SER have suggested an initial myopic shift after horizontal muscle surgery, it remains controversial as to whether the myopic shift is transient or permanent [710]. Pineles et al[13] reported that patients with lateral incomitance was at increased risk of requiring reoperation. Habot-Wilner Z, Spierer A, Barequet IS, Wygnanski-Jaffe T. Long-term results of esotropia surgery in children with developmental delay. Liebermann L, Hatt SR, Leske DA, Holmes JM. 1Department of Ophthalmology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China, 2Department of Ophthalmology, Weihai Municipal Hospital, Weihai 264200, Shandong Province, China. Investigation, Horizontal muscle surgery has no long-term effect on the change in the spherical equivalent. Bethesda, MD 20894, Web Policies Although the results suggest that strabismus surgery seems to have minimal long-term effects on changes in refractive error, postoperative changes in astigmatism were sustained. The larger the deviation angle at a distance, the greater the postoperative change toward WTR astigmatism. Exotropia may occur from time to Exotropia The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). To evaluate the long-term refractive changes after horizontal muscle surgery in patients with intermittent exotropia and investigate the correlation between changes in the postoperative refractive error and clinical factors. 2022 Jul;42(7):2195-2204. doi: 10.1007/s10792-022-02219-3. Although marginal myotomy is no longer a routine weakening procedure, it should not be completely abandoned, because it is a useful technique when an already recessed muscle requires additional weakening. Exotropia: Symptoms, Management, and More Click through the PLOS taxonomy to find articles in your field. The authors concluded that unilateral lateral rectus resection was an effective method in the treatment of undercorrected or recurrent esotropia and it was predictable, stable in the immediate in postoperative period, and limited surgery to one eye. For measurement of preoperative refraction, cycloplegia was induced by three cycles of one drop of 1% cyclopentolate and one drop of 1% tropicamide, administered 5 min apart. Primary exotropia. Yazdian Z, Ghiassi G. Re-recession of the lateral rectus muscles in patients with recurrent exotropia. Bilateral medial rectus resections can be applied to the patients with undercorrected or recurrent exotropia after bilateral lateral rectus recessions for exotropia, while unilateral medial rectus resection can be appropriate for small-angle recurrent exodeviation. All procedures were performed by a single surgeon (SJK) under general anaesthesia. This occurs when the eye turn is present all of the time, at all distances. WebIntermittent exotropia: In this type of strabismus, one eye will fixate (concentrate) on a target while the other eye points outward. Park JH, Kim SH. Bookshelf First, due to the retrospective nature of the study, we were unable to obtain data on potential confounding factors for refractive error such as family history, outdoor activities, or near work. The operated eyes consistently and significantly showed higher cylindrical power in WTR astigmatism than the fellow eyes. In those rare cases in which conventional recession of a rectus muscle cannot be done because of retinal supports near the muscle insertion or because of scleral thinning, it may even be the primary procedure of choice. To investigate the symptoms of attention deficit hyperactivity disorder (ADHD) as reported by parents in children with intermittent exotropia [X(T)] and to determine whether All data were fully anonymized and the requirement for informed consent was waived owing to the retrospective study design. One eye is either constantly or intermittently turned in (esotropia) or In addition, monocular occlusion test was performed at least once before surgery. The surgery for consecutive exotropia had been performed at a mean age of 35.92 18.26 years. WebMicrostructural properties of major white matter tracts in constant exotropia before and after strabismus surgery Br J Ophthalmol. persimnon 1 min. National Library of Medicine Future prospective and randomized controlled studies with larger samples are needed to provide reliable information for guiding the design of operation style for residual or recurrent strabismus. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical University. No, Is the Subject Area "Cataract surgery" applicable to this article? POST-OPERATIVE INSTRUCTIONS FOR Because strabismus surgery affects not only simple ocular deviations but also complex neuromuscular and sensory systems, many pediatric ophthalmologists have to confront the frustrating postoperative problems and treat them with empirical surgical procedures. J Pediatr Ophthalmol Strabismus. One muscle strabismus surgery. The mean age at surgery was 7.52.4years, and girls accounted for 56.1% of the study population. Strabismus Post-occlusion angle of deviation was measured before reestablishment of binocularity. Surgery was performed on the non-dominant eye in patients who showed fixation preference. Olitsky et al[19] reviewed 21 patients who underwent unilateral medial rectus resection for correcting undercorrected or recurrent exotropia (mean deviation, 16.6 PD). In 19 of these patients, surgery of consecutive exotropia involved at least one previously operated extraocular muscle, and the mean interval to the previous surgery was 25.67 16.14 years. The use of adjustable sutures can provide an improved success rate in patients undergoing reoperations. One study found that certain people had a higher risk for developing consecutive exotropia after a procedure than others. No, Is the Subject Area "Eye muscles" applicable to this article? WebPurpose: To investigate health-related quality of life (HRQOL) after strabismus surgery in children with intermittent exotropia (IXT) and relationships between HRQOL and surgical success. Surgical management of intermittent exotropia: do we have an The condition can be further described by the direction of the misalignment. Clark RA, Ariyasu R, Demer JL. This site needs JavaScript to work properly. exotropia A paired t-test and analysis of variance were used to compare preoperative clinical characteristics. Binocular function was tested using the Worth four-dot test and stereoacuity was measured using the Titmus stereo test (Stereo Optical, Chicago, Illinois, USA) when cooperation was adequate. Although Exotropia commonly begins around age 2 to 4 years, it can appear at any age. It also allows to specify factorial interactions. Most of the patients showed some mild limitation of adduction after the surgery, but this deficiency was generally not a significant cosmetic or functional defect. 2019 Jul;39(7):1427-1436. doi: 10.1007/s10792-018-0956-5. For more information about PLOS Subject Areas, click The authors concluded that large unilateral medial rectus resection was a safe and effective procedure in the treatment of small to moderate angles of recurrent exotropia after bilateral lateral rectus recession. Eye Exercises for Strabismus - WebMD There were 62 cases of contradictory diplopia (83.78%) and 12 cases of fusion of powerless diplopia (16.22%). Improved ocular alignment with adjustable sutures in adults undergoing strabismus surgery. What to Expect After Strabismus (Eye Muscle) Surgery Exodeviations can be congenital or acquired. Federal government websites often end in .gov or .mil. These findings were similar to the results of Koklanis and Georgievski[18]. The authors concluded that unilateral medial rectus resection was an effective surgical method for the correction of small to moderate angle recurrent exotropia. In some instances, Bethesda, MD 20894, Web Policies Residual or recurrent strabismus is common problem found after the strabismus operations. The .gov means its official. They believe that unilateral surgery can be appropriate for residual esotropia of up to 15 PD. HHS Vulnerability Disclosure, Help In summary, horizontal muscle surgery had no long-term effect on myopia progression. Sprunger DT, Wasserman BN, Stidham DB. Wang L, Nelson LB. Unilateral rectus resection in the treatment of undercorrected or recurrent strabismus. Nucci et al[42] reported the results of unilateral lateral rectus resection in 35 patients for the treatment of small-angle residual esotropia after bilateral medial rectus recession with a 6mo follow-up. Factors associated with horizontal reoperation in infantile esotropia. However, there was no significant difference in stereopsis or binocular function among the groups. Clipboard, Search History, and several other advanced features are temporarily unavailable. Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea, We found that the changes in SER did not differ between the operated and fellow eyes, whereas astigmatism was more changed toward WTR astigmatism in the operated eyes. [ 1 3] The prevalence of consecutive exotropia has been reported as being from 3% to 29% [ 1, 2, 4 6] following surgery for esotropia and higher rates have been reported with longer follow-up. 2021 Jan 19;bjophthalmol-2020-317948. WebEye Exercises as Therapy Treatment is vision therapy. Previous studies have compared the refractive error between the preoperative and immediate postoperative periods to isolate the surgical effect on refractive error. To the best of our knowledge, this is the first study to measure the effect of plication on postoperative refractive error, and the results showed that RP had less of an effect on astigmatism than RR or LRc. e0280274. https://doi.org/10.1371/journal.pone.0280274.t004. This implies that the surgery might have initial effects on the change in astigmatism within three months and not have additional impact thereafter. strabismus Marginal myotomy of the medial rectus with lateral rectus resection as a secondary procedure for esotropia. This may prevent postoperative astigmatism changes. Strabismus is an eye condition in which the eyes are misaligned. In addition, the magnitude of refractive changes and their clinical significance remains controversial. In our previous retrospective study, we found that using the strabismus surgery dosages established by western strabismus mentors tends to result in undercorrection of Taiwanese exotropia (XT) patients compared with those in western populations. WebYou may need eye muscle surgery if you have: Exotropia: One or both of your eyes turn outward toward your ears. The authors concluded that bilateral lateral rectus re-recession to 17 mm from the limbus was an effective and alternative surgical procedure for the treatment of recurrent exotropia up to 33 PD. Medial rectus pulley posterior fixation: a novel technique to augment recession. Please enable it to take advantage of the complete set of features! WebPerforming strabismus surgery with consecutive exotropia results in restoration of some binocularity in a large number of patients, even in adults, and should be considered as a Comparison of surgical outcomes between lateral rectus recession All statistical analyses were performed using SAS version 9.4 (SAS Institute Inc., Cary, North Carolina, USA), and p-values of < 0.05 were considered significant. Before Shin et al[38] found that bilateral lateral rectus resection was an effective surgical method for treating residual esotropia of less than 40 PD after bilateral medial rectus recession. National Library of Medicine Vishakha_66 Exotropia. Therefore, this would have little effect on the results. Clinical features and the risk factors of infantile exotropia recurrence. Constant. McPhee TJ, Dyer JA, Ilstrup DM. Intermittent Exotropia - American Academy of Strabismus surgery can help to preserve or restore the binocular vision in IXT. Hoerantner R, Priglinger S, Haslwanter T. Reduction of ocular muscle torque by splitting of the rectus muscle II: technique and results.
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