The surgical management of consecutive exotropia

Donaldson, M. J., Forrest, M. P. and Gole, G. A. (2004) The surgical management of consecutive exotropia. Journal of Aapos, 8 3: 230-236. doi:10.1016/j.jaapos.2004.01.001

Author Donaldson, M. J.
Forrest, M. P.
Gole, G. A.
Title The surgical management of consecutive exotropia
Journal name Journal of Aapos   Check publisher's open access policy
ISSN 1091-8531
Publication date 2004-06
Sub-type Article (original research)
DOI 10.1016/j.jaapos.2004.01.001
Volume 8
Issue 3
Start page 230
End page 236
Total pages 7
Place of publication USA
Publisher Mosby Inc
Collection year 2004
Language eng
Subject C1
321016 Opthalmology and Vision Science
321029 Surgery
730111 Hearing, vision, speech and their disorders
730204 Child health
1113 Ophthalmology and Optometry
1114 Paediatrics and Reproductive Medicine
Abstract Purpose: To review the results and techniques of surgical treatment of consecutive exotropia. Methods: We performed a retrospective chart review of all patients who underwent surgery for consecutive exotropia in a pediatric ophthalmology practice between 1992 and 2001. Patients were excluded if follow-up lasted < 6 weeks or if exotropia was caused by other ocular disorders such as previous trauma or congenital cataracts. Results: Fifty-nine patients were identified. The procedure performed in the majority of cases was unilateral lateral rectus recession and medial rectus advancement to the original insertion. Seven patients underwent bilateral lateral rectus recession, and 6 underwent lateral rectus recession combined with medial rectus resection. The mean interval between original surgery and surgery for consecutive exotropia was 14.1 years (range 4 months to 47.5 years). The mean preoperative distance exodeviation was 31.7 prism diopters (PD). Satisfactory alignment lie, within 10 PD of orthophoria) was achieved in 36 patients (61%) at week 1 and 42 patients (71%) at final follow-up. Mean follow up was 16.0 months. Thirty-nine patients (66%) demonstrated an exodrift after surgery (mean 7.6 PD). Conclusion: Consecutive exotropia may occur many years, even decades, after esotropia surgery. Lateral rectus recession with advancement of the previously recessed medial rectus is an effective treatment. An exotropic drift occurs after consecutive exotropia surgery, usually within the first 6 weeks. A suitable ocular alignment immediately after surgery for consecutive exotropia is a small-angle esotropia of 5 to 10 PD.
Keyword Ophthalmology
Medial Rectus Recession
Congenital Esotropia
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2005 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 28 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 30 times in Scopus Article | Citations
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Created: Wed, 15 Aug 2007, 05:15:34 EST