Relation between early postoperative deviation and long-term outcome after unilateral lateral rectus recession and medial rectus resection for adult exotropia

摘要

AIM: To evaluate the relationship between early postoperative deviation and long-term outcome after unilateral recession and resection surgery for adult exotropia, and to evaluate exotropic shift after surgery.METHODS: This was a retroprospective study involving adult patients with exotropia who underwent unilateral recession and resection surgery and were followed up for at least 2 y. The results were evaluated at 2 y and the final visit. Factors influencing a successful outcome were analyzed. Early postoperative deviation at 1 wk was used to evaluate relationship with long-term outcome. The longterm outcome was classified into 3 groups: successful, acceptable, and poor. Successful outcome was defined as a distance deviation between esodeviation 8 prism diopters(PD) and exodeviation 10 PD.RESULTS: Forty-two patients were enrolled. The mean age at surgery was 26 y(range, 15-49 y). The median follow-up period was 30 mo(range, 24-108 mo). Successful outcome was found in 81% of patients at 2 y and in 71% at the final visit. Overcorrection at 1 wk postoperatively was associated with a successful outcome at 2 y. Initial postoperative alignment between orthotropia and esodeviation of 8 PD had the highest chance of a successful outcome(RR=2.2). The mean postoperative exotropic drift was 4.7 PD at the first month and 9.3 PD at 2 y.CONCLUSION: Initial postoperative deviation can predict long-term outcome after unilateral recession and resection surgery for adult exotropia. The most desirable outcome at 1 wk post-operatively was orthotropia to small esodeviation. Most patients have exotropic drift at a subsequent follow-up, especially in the first month after surgery.