Journal of American Association for Pediatric Ophthalmology and Strabismus
Major articleSurgical Experiences With Two-Muscle Surgery for the Treatment of Intermittent Exotropia
Section snippets
Methods
All children younger than 16 years who underwent 2-muscle surgery for intermittent exotropia at the Singapore National Eye Centre (SNEC) between January 1992 and December 1995 were included in this study. Surgery was performed by 3 surgeons. Only those patients with X(T) with basic (B) or divergence excess (DE) X(T) and with distant strabismus size between 25 and 50 prism diopters (PD) were included.
Those children with constant exotropia or convergence-insufficiency X(T), past extraocular
Results
Using the hospital database, 203 patients were found to have had surgery for intermittent exotropia in the 4 years between January 1992 and December 1995. Of these, 2 had X(T) greater for near than distance. Thirty-one had 3-muscle surgery. An additional 45 patients had concurrent oblique muscle surgery. One had adjustable suture surgery. Six had inadequate follow-up. These patients were excluded from the study. The remaining 118 patients satisfied the entry requirements of this study.
Discussion
The surgical management of intermittent exotropia has been frustrating in its unpredictability. “Success rates” reported range from 40% to 83% (Table 5).1, 2, 3, 4, 5, 6, 7, 8, 9 Determining how much surgery to do itself is fraught with difficulty (Table 4). Using preoperative strabismus size measurement alone does not appear to provide predictable result. Many authors have looked at the various factors that may influence outcome (eg, type of surgery, age of surgery, amount of stereopsis, high
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