Relationship between motor alignment at postoperative day 1 and at year 1 after symmetric and asymmetric surgery in intermittent exotropia.
OBJECTIVE
To evaluate the relationship between the motor alignment at postoperative day 1 and at year 1 following bilateral lateral rectus recession (BLR, symmetric surgery) and unilateral lateral rectus recession-medial rectus resection (R&R, asymmetric surgery) for the treatment of intermittent exotropia, X(T).


METHODS
Forty-six patients with basic or pseudo-divergence excess type of X(T) underwent BLR and 57 patients underwent R&R. The motor alignment at postoperative day 1 was classified as overcorrected by 11-20 prism diopters (PD), overcorrected by 1-10 PD, orthotropic, or undercorrected by 1-10 PD of exotropia.


RESULTS
There was a statistically significant relationship between the alignment at postoperative day 1 and at year 1 following both R&R and BLR surgery (r = 0.74, r = 0.51, respectively, P <.05). Patients overcorrected by 1-20 PD had a significantly higher success rate than those undercorrected by 1-10 PD on postoperative day 1 (P <.05). For R&R, a postoperative day 1 alignment of 1-10 PD resulted in the highest success rate of 73.7%. For BLR, a postoperative day 1 alignment of 11-20 PD showed the highest success rate of 76.9%. There were no significant differences in the success, undercorrection and overcorrection rates between the two surgical procedures after a 1-year postoperative period.


CONCLUSIONS
The alignment at postoperative day 1 can be a predictive factor of the surgical outcome in X(T). A postoperative day 1 overcorrection of 11-20 PD following BLR surgery and an overcorrection of 1-10 PD following R&R can lead to good results.
Lee
S
S
Department of Ophthalmology, College of Medicine, Keimyung University, Taegu City, South Korea.
Lee
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YC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005099:Exotropia / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology* / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures; D011184:Postoperative Period; D013997:Time Factors; D015348:Vision, Binocular