title: Timing of surgery for primary exotropia in children.
abstract: OBJECTIVE
  To compare the postoperative alignment and sensory functions in patients with primary exotropia who had been operated at an early age (< 7 years) with those in patients who had been operated at an older age (> 7 years).
  
  
  METHODS
  In a consecutive retrospective cohort study, 112 patients who had had a surgical intervention for primary exotropia between 1997 and 2003 were evaluated for postoperative results. After applying criteria for eligibility, the group of patients was divided into two groups: those who had had surgery before the age of seven years (n = 24) and those who had had surgery after the age of seven years (n = 36). Age at surgery, preoperative alignment and sensory functions were correlated with the postoperative status. The follow-up was at least one year (1.0 year to 7 years; median: 2.3 and 3.5 years, respectively).
  
  
  RESULTS
  Patients who had had surgery before the age of seven had significantly better alignment and sensory functions. The univariate logistic regression model confirmed a statistically significant association between motor outcome (exodeviation less than 10 diopters) and age at the time of surgery (before or after the age of seven; p = 0.002). In the multivariate model, the association between age at time of surgery and motor outcome was even stronger. The number of re-operations in the group operated before the age of 7 years was significantly less than in the group operated after the age of seven (2 versus 12, p = 0.023).
  
  
  CONCLUSIONS
  The postoperative alignment and sensory functions for patients with primary exotropia who had had a surgical intervention before the age of seven years were, in this study, better than those in patients who had had surgery after the age of seven years.
authors.affiliation: Orthoptist, Diaconessenhuis Meppel, Meppel, The Netherlands.
authors.forename: W L
authors.initials: WL
authors.lastname: Asjes-Tydeman
authors.forename: H
authors.initials: H
authors.lastname: Groenewoud
authors.forename: G J
authors.initials: GJ
authors.lastname: van der Wilt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors