This review was conducted to address a number of questions: (1) define successful surgical outcome; (2) criteria for successful alignment, (3) consideration of aetiology when deciding surgery, and (4) are visual acuity, fusion and stereoacuity routinely investigated as surgical outcomes? The review included 74 studies from first search and 97 studies from a second search using different search terms. Combined, the review included 102 studies (12,974 subjects). Most (91%) studies did not consider aetiology of intermittent exotropia. For criteria for success, 82% defined this specifically on ocular alignment and 87.5% provided a definition. The definition success had 34 different definitions – mostly related to the angle at distance, near and near-distance difference. For visual acuity and stereoacuity, postoperative visual acuity was outlined in 3 studies. Sensory outcomes were reported in 61 studies. Mean success rate was 63.67 ±17.08%. Mean follow-up period was 34.44 ±39.56 months. Mean success rate reduced with longer follow-up although this was a weak correlation. The authors conclude that aetiology is not considered when deciding surgery, with surgical success based on primary angle of deviation independent to visual acuity and sensory outcomes.
Choice and definitions of surgical outcomes for intermittent exotropia
Reviewed by Fiona Rowe
Surgical outcomes and etiological considerations in intermittent exotropia: a systematic narrative review.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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