The purpose of this study was to report long-term motor and sensory outcomes after unilateral lateral/medial rectus recession/resection (RR) in infantile constant exotropia. This was a retrospective review from 1995–2020 of 20 children (10 female, 10 male) with minimum 4-year follow-up. Onset was from birth for 9 and from 1–6 months of age for 11. Mean age at presentation was 2.02 ±1.33 years and 3.21 ±1.54 years at time of surgery. Preoperative mean angle was 70.1 ±20.9PD; 4 measured <50PD. Sixteen had refractive error with mean spherical equivalent of 1.23 ±1.01D (range -0.75 to +3.50D for the right eye and -1.25 to +4.50D for the left eye). Five had strabismic amblyopia and underwent occlusion therapy. Ten required 1 surgical procedure and 10 had a second surgery for residual exotropia (most of the latter had initial exotropia of >50PD). Two developed consecutive esotropia after surgery. Postoperatively, 4 developed dissociated vertical deviation (DVD) at a mean of 7.88 ±5.51 years and 2 developed inferior oblique overaction at a mean of 9.0 ±2.83 years. At last follow-up, twelve had surgical success, 4 residual exotropia, 3 recurrent exotropia and 1 consecutive esotropia. Binocular vision information was available for twelve patients: 3 positive for peripheral binocular vision and 9 negative with no stereopsis for any patient. Age at surgery and duration of exotropia had no effect on outcome for motor and sensory factors.
Outcome of surgery for infantile exotropia after long-term follow-up of 4 years
Reviewed by Fiona Rowe
Long-term motor and sensory outcomes after unilateral lateral rectus recession / medial rectus resection for infantile constant exotropia.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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