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KMID : 0360220180590030276
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Journal of the Korean Ophthalmological Society
2018 Volume.59 No. 3 p.276 ~ p.281
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Risk Factors for Consecutive Exotropia and Hyperopic Changes after Bilateral Medial Rectus Recession
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Lee Ki-Woong
Paik Hae-Jung
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Abstract
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Purpose: To define risk factors for and to analyze changes in hyperopic refractive error during development of postoperative exotropia (XT) after bilateral medial rectus (BMR) recession to treat infantile esotropia.
Methods: We retrospectively examined 50 patients with infantile esotropia who underwent BMR recession from January 2005 to December 2010. All were <10 years of age and underwent ≥36 months of follow-up. We recorded age at operation, the preoperative strabismus angle, the extent of medial rectus recession, strabismus status, pre- and post-operative changes in the refractive errors of both eyes, any postoperative overcorrection, any dissociated vertical deviation (DVD), and inferior oblique overaction (IOOA) status.
Results: Consecutive XT developed in 18 (36%) patients. The preoperative refractive error was +0.90 ± 0.79 D in the consecutive XT group and +1.94 ± 1.48 D in the surgical success (SS) group (p = 0.019). The extent of hyperopic decrease was significantly greater in the consecutive XT group than the SS group (consecutive XT group: 1.59 ± 1.38 D, SS group: 2.86 ± 1.97 D) at 3 years of post-operative follow-up (p = 0.008). Postoperative IOOA was detected in 10 (70.5%) patients in the consecutive XT group and 3 (29.55%) in the SS group (p = 0.002). No significant between-group difference in the incidence of overcorrection or DVD was apparent.
Conclusions: The presence of hyperopia (>+2.0 D) prior to BMR recession and a marked fall in the extent of hyperopia (?1.0 D/year) after recession may be associated with a high risk of consecutive XT. Thorough follow-up is necessary when IOOA develops after BMR recession.
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KEYWORD
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Consecutive exotropia, Hyperopia, Infantile esotropia, Myopic change, Risk factor
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