Changes Over Time in the Angle of Strabismus after Surgery for Intermittent Exotropia

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  • Tokutake Tomoki
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center
  • Hasebe Kayoko
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center
  • Imai Toshihiro
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center
  • Nagata Yuka
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center
  • Nagao Sachina
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center
  • Arai Saki
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center
  • Son Iei
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center Department of Ophthalmology 2, Kawasaki Medical School
  • Kobashi Rie
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center Department of Ophthalmology 2, Kawasaki Medical School
  • Furuse Takashi
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center Department of Ophthalmology 2, Kawasaki Medical School
  • Hasebe Satoshi
    Department of Ophthalmology, Kawasaki Medical School, General Medical Center Department of Ophthalmology 2, Kawasaki Medical School

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  • 間欠性外斜視術後の斜視角の経時的変化

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<p>[Purpose] To assess and compare the changes over time in the angle of strabismus and investigate the factors for prognosis.</p><p>[Methods] Among 57 patients who had undergone unilateral rectus muscle recession-resection for intermittent exotropia at the age of 15 years or younger and had been followed up for at least 3 years, 52 were included excluding the 5 patients with a second surgery. Those with an angle of strabismus between 15 PD exodeviation and 5 PD esodeviation at postoperative 36 months were assigned to the "good outcome" group and the rest to the "poor outcome" group. The distant vision angles of strabismus were measured at the time points of postoperative 1 week and 1, 3, 6, 12, 24, and 36 months; and the differences between the time points were defined as the changes in the angle of strabismus. To investigate the factors for prognosis, we compared some clinical parameters between the two groups.</p><p>[Results] At postoperative 1 week, the angles of strabismus (mean ± SD) were +16.5 ± 7.6 PD ( "+" for esodeviation) for the "good outcome" group and +10.7 ± 8.2 PD for the "poor outcome" group, showing a significant difference. Both groups showed exodrift over the study period. The change in the angle of strabismus appeared to be large between postoperative 1 week and 1 month (8.2 ± 7.0 PD for the "good outcome" group and 6.0 ± 4.7 PD for the "poor outcome" group) and gradually decreased afterward. Although both groups showed significant differences in the angle change between the periods of postoperative 1-week to 1-month and 1-month to 3-month, and 1-month to 3-month and 3-month to 6-month, no significant difference was observed between any periods after postoperative 6 months. Moreover, no significant difference in the amount of angle change was seen between the two groups in any period. </p><p>[Conclusion] The change over time in the angle of strabismus stabilized around postoperative 3 months and remained stabilized for 3 years. The amounts of change were not significantly different between the "good outcome" and "poor outcome" groups. The outcomes at postoperative 3 years were likely to depend on the degree of over-correction immediately after surgery.</p>

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