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Postoperative minimal overcorrection in the surgical management of intermittent exotropia
  1. Yoonae A Cho,
  2. Seung-Hyun Kim
  1. Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Dr Seung-Hyun Kim, Department of Ophthalmology, Korea University, Ansan Hospital, 516 Gojan-dong, Gyunggi-do, Ansan 425–707, Republic of Korea; ansaneye{at}hanmail.net

Abstract

Purpose To investigate the effect of initial postoperative minimal overcorrection on the result of the surgical management of intermittent exotropia based on long-term follow-up results.

Methods 111 patients who underwent surgery for intermittent exotropia and were followed up for at least 5 years after surgery were retrospectively reviewed. The outcome was judged to be successful when there was 10 prism dioptres (PD) or less of exodeviation and less than 5 PD of esodeviation without any reoperation at the final follow-up visit. We evaluated the success, recurrence, overcorrection rate and the duration of diplopia according to their initial deviation.

Results We divided patients into four groups based on their initial deviation: orthophoria or undercorrection (Ortho group, 31 patients), minimally overcorrected at 5 PD or less (MO group, 20 patients), usually overcorrected between 6 PD and 10 PD (UO group, 35 patients), and highly overcorrected at more than 10 PD (HO group, 25 patients). The success rate was 43–60% between the four groups (p=0.52). The recurrence rate was 28–57% (p=0.105), but post hoc analysis showed borderline p values between the Ortho and HO group (p=0.024). No overcorrection was noted in the Ortho and MO groups (p=0.04). The duration of diplopia was 0–2.5 weeks, showing statistically significant difference among groups (p<0.001).

Conclusions The amount of initial postoperative overcorrection may not predict the long-term success rate. However, the MO group showed a lower recurrence rate than the Ortho group and also showed no overcorrection and a shorter duration of postoperative diplopia than the UO and HO groups.

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