Publication: Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
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Issued Date
2018-01-01
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ISSN
11775483
11775467
11775467
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2-s2.0-85057714539
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Ophthalmology. Vol.12, (2018), 1763-1767
Suggested Citation
Apatsa Lekskul, Tatha Supakitvilekarn, Tanyatuth Padungkiatsagul Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia. Clinical Ophthalmology. Vol.12, (2018), 1763-1767. doi:10.2147/OPTH.S174695 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/47054
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Title
Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
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Abstract
© 2018 Lekskul et al. Purpose: To study the surgical outcomes of intended undercorrection on adult intermittent exotropia (X(T)) performed to avoid postopertively overcorrected diplopia. Patients and methods: A retrospective chart review was conducted for adult patients (age ≥18 years) with X(T) ≥15 prism diopter (PD) who underwent strabismus surgery by a single surgeon. Inclusion criteria were 1) corrected VA ≥20/40 in either eye; 2) monocular occlusion at least 30 minutes before deviation measurement; 3) difference of 10 PD between near and distance deviation; 4) absence of significant A or V pattern or vertical deviation; 5) lateral rectus recession and medial rectus resection procedure were performed unilaterally; and 6) intended surgical number for deviation correction was aimed at 5 PD undercorrection. Results: Of 234 patients who met the inclusion criteria, 122 were women (52.14%). Average age at the time of surgery was 27.56 years (range, 18–42 years). A total number of 197 patients (84.19%) had postoperative exodeviation under 10 PD. Twenty five (10.68%) and 12 patients (5.13%) had postoperative exodeviation within 10–15 PD and 15 PD, respectively. All patients who had postoperative exodeviation 15 PD exhibited initial deviation of 40 PD and had undergone re-operation. In 74 patients (46.25%) out of 160 who had no binocular vision in orthoptic examination before surgery, fusion or stereopsis was gained after good alignment. No postoperative diplopia was found in this study. Conclusion: Intended undercorrection in surgical management of adult X(T) showed good functional and cosmetic outcomes. No procedure resulted in consecutive esodeviation or persistent diplopia. Fusion or stereopsis could be gained after successful surgical alignment. Our recommendations are as follows: 5 PD undercorrection if deviation is 40 PD and regular correction if deviation is 40 PD.