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Comparison of surgery versus observation for small angle intermittent exotropia

In young children with small angle exotropia, making decisions for the individual patient whether to perform surgery or not, and choosing the optimal time for surgical intervention are quite difficult. We aimed to compare the long-term outcomes of small angle intermittent exotropia of 20 prism diopt...

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Autores principales: Sung, Jae Yun, Yang, Hee Kyung, Hwang, Jeong-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070054/
https://www.ncbi.nlm.nih.gov/pubmed/32170126
http://dx.doi.org/10.1038/s41598-020-61568-0
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author Sung, Jae Yun
Yang, Hee Kyung
Hwang, Jeong-Min
author_facet Sung, Jae Yun
Yang, Hee Kyung
Hwang, Jeong-Min
author_sort Sung, Jae Yun
collection PubMed
description In young children with small angle exotropia, making decisions for the individual patient whether to perform surgery or not, and choosing the optimal time for surgical intervention are quite difficult. We aimed to compare the long-term outcomes of small angle intermittent exotropia of 20 prism diopters (PD) or less after observation versus strabismus surgery. A retrospective study was performed on 164 patients aged 3 to 13 who underwent surgical intervention or observation with or without conservative management for intermittent exotropia of 14 to 20 PD. The minimum follow-up period was 2 years. The average follow-up period was 3.9 ± 2.2 years in the observation group and 4.5 ± 2.3 years in the surgery group. At the final examination, the mean angle of deviation at distance was 11.1 ± 8.9 PD in the observation group and 9.0 ± 7.5 PD in the surgery group, which was not significantly different (P = 0.121). Changes in sensory outcome and fusional control were not significantly different between both groups (P = 0.748 and P = 0.968). Subgroup analysis including patients with poor fusional control also showed similar results. By multivariate analysis, the type of surgery, unilateral recess-resect procedure, was the only predictive factor of good motor outcome in the surgery group. In conclusion, long-term surgical outcomes in small angle exotropia did not appear to be more satisfying than observation in terms of motor and sensory outcomes.
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spelling pubmed-70700542020-03-22 Comparison of surgery versus observation for small angle intermittent exotropia Sung, Jae Yun Yang, Hee Kyung Hwang, Jeong-Min Sci Rep Article In young children with small angle exotropia, making decisions for the individual patient whether to perform surgery or not, and choosing the optimal time for surgical intervention are quite difficult. We aimed to compare the long-term outcomes of small angle intermittent exotropia of 20 prism diopters (PD) or less after observation versus strabismus surgery. A retrospective study was performed on 164 patients aged 3 to 13 who underwent surgical intervention or observation with or without conservative management for intermittent exotropia of 14 to 20 PD. The minimum follow-up period was 2 years. The average follow-up period was 3.9 ± 2.2 years in the observation group and 4.5 ± 2.3 years in the surgery group. At the final examination, the mean angle of deviation at distance was 11.1 ± 8.9 PD in the observation group and 9.0 ± 7.5 PD in the surgery group, which was not significantly different (P = 0.121). Changes in sensory outcome and fusional control were not significantly different between both groups (P = 0.748 and P = 0.968). Subgroup analysis including patients with poor fusional control also showed similar results. By multivariate analysis, the type of surgery, unilateral recess-resect procedure, was the only predictive factor of good motor outcome in the surgery group. In conclusion, long-term surgical outcomes in small angle exotropia did not appear to be more satisfying than observation in terms of motor and sensory outcomes. Nature Publishing Group UK 2020-03-13 /pmc/articles/PMC7070054/ /pubmed/32170126 http://dx.doi.org/10.1038/s41598-020-61568-0 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Sung, Jae Yun
Yang, Hee Kyung
Hwang, Jeong-Min
Comparison of surgery versus observation for small angle intermittent exotropia
title Comparison of surgery versus observation for small angle intermittent exotropia
title_full Comparison of surgery versus observation for small angle intermittent exotropia
title_fullStr Comparison of surgery versus observation for small angle intermittent exotropia
title_full_unstemmed Comparison of surgery versus observation for small angle intermittent exotropia
title_short Comparison of surgery versus observation for small angle intermittent exotropia
title_sort comparison of surgery versus observation for small angle intermittent exotropia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070054/
https://www.ncbi.nlm.nih.gov/pubmed/32170126
http://dx.doi.org/10.1038/s41598-020-61568-0
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