Poster 196

by in  Poster Session 3


Comparison of Immediate and Long-Term Outcomes in Basic Exotropia Treated with and without Adjustable Suture Strabismus Surgery

Majid Rouhbakhshzaeri, MD; In Ae Jang; Mehmet C. Mocan; Nathalie Azar
University of Illinois at Chicago, Department of Ophthalmology
Chicago, IL


Introduction: The purpose of this clinical study was to evaluate the immediate and long-term postoperative anatomic and functional outcomes of non-adjustable versus adjustable suture strabismus surgery in basic exotropia.

Methods: Patients with the diagnosis of basic exotropia whose near-distance disparities were within 10 prism diopters (PD) and who underwent surgical correction were included in the study. Clinical data including pre- and post-operative alignments at near and distance fixation were included in analysis. All patients who underwent adjustable suture surgery were left with a small angle (4-6PD) esodeviation at distance immediately following adjustment. The target alignments for non-adjustable group were based on standard surgical tables. Post-operative success was defined as alignment within 8 PD at the end of 6 months of follow-up.

Results: The overall success rate at the end of 6 months follow-up was 62.8% for adjustable suture group (n=34) and 66.6% for non-adjustable group (n=35) (p=0.749). The mean pre-operative distance deviation for the adjustable and the non-adjustable group was 40.5±19.9 PD and 34.0±12.5, respectively (p=0.116). The mean postoperative deviations at distance for patients who underwent adjustable versus non-adjustable suture were 6.9±9.2 PD and 6.6±10.1 PD, respectively (p=0.884).

Discussion: Our results reveal that, in patients with basic type of exotropia, adjustable and non-adjustable suture surgeries have similar success rates at the end of the initial 6 month follow-up period following successful surgical alignment.

Conclusion: Successful alignment is achieved in two thirds of patients with basic exotropia at the end of 6 months postoperative follow-up.

References: 1. Govindan M, Mohney BG, Diehl NN, et al. Incidence and types of childhood exotropia. Ophthalmology 2005; 112:104-108.
2. Choi J, Kim SJ, Yu YS. Initial postoperative deviation as a predictor of long-term outcome after surgery for intermittent exotropia. J AAPOS. 2011;15(3):224-229.
3. Mireskandari K, Schofield J, Cotesta M, Stephens D, Kraft SP. Achieving postoperative target range increases success of strabismus surgery in adults: a case for adjustable sutures? Br J Ophthalmol.|2015 Dec;99(12):1697-701.

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