Consecutive esotropia in intermittent exotropia patients with immediate postoperative overcorrection more than 17 prism diopters.
OBJECTIVE
To report the incidence and the factors of consecutive esotropia (ET) in patients with immediate postoperative overcorrection of at least 17 prism diopters (PD) after surgery for intermittent exotropia (X(T)).


METHODS
Four-hundred-five patients under the age of 18 were included in this study. They underwent bilateral lateral rectus recession (LROU-rec) or unilateral recession-resection (R&R) for X(T). On postoperative day one, the patients with at least 17 PD overcorrection were classified as group 1 and those with less than 17 PD as group 2. Age, refractive error, type of surgery, lateral incomitancy, and the incidence of consecutive ET were analyzed for each group.


RESULTS
Group 1 consisted of 116 patients (28.6%) and group 2 consisted of 289 (71.4%). At the six-month follow-up visit, consecutive ET had developed in 16 patients (13.8%) in group 1, and in five patients (1.7%) in group 2 (p<0.001). The occurrence of consecutive ET was not related to age at the time of surgery (p=0.46 in group 1; p=0.54 in group 2), refractive error (p=0.18 in group 1; p=0.08 in group 2), or the type of surgery (p=0.69 in group 1; p=1.00 in group 2). The incidence in group 1 was 23.8% in patients with lateral incomitancy and 8.1% in patients without lateral incomitancy (p<0.05). In group 2, the incidence was 4.4% in patients with lateral incomitancy and 0.5% in patients without lateral incomitancy (p=0.04).


CONCLUSIONS
Consecutive ET developed in 13.8% of patients with immediate overcorrection of at least 17 PD. Lateral incomitancy was the most important risk factor.
Kim
Hyoung-Seok
HS
Department of Ophthalmology, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Suh
Young-Woo
YW
Kim
Seung Hyun
SH
Cho
Yoonae A
YA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D012720:Severity of Illness Index