Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia

Apatsa Lekskul, Tatha Supakitvilekarn, Tanyatuth Padungkiatsagul Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Purpose: To study the surgical outcomes of intended undercorrection on adult intermittent exotropia (X(T)) performed to avoi...

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Autores principales:	Lekskul A, Supakitvilekarn T, Padungkiatsagul T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Diplopia Intermittent exotropia Stereopsis Fusion Recession Resection Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/520985bdf20843a89b59e6eabd767023
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spelling	oai:doaj.org-article:520985bdf20843a89b59e6eabd7670232021-12-02T00:37:23ZOutcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia1177-5483https://doaj.org/article/520985bdf20843a89b59e6eabd7670232018-09-01T00:00:00Zhttps://www.dovepress.com/outcomes-of-undercorrection-in-surgical-management-and-binocular-visio-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Apatsa Lekskul, Tatha Supakitvilekarn, Tanyatuth Padungkiatsagul Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Purpose: To study the surgical outcomes of intended undercorrection on adult intermittent exotropia (X(T)) performed to avoid postopertively overcorrected diplopia.Patients and methods: A retrospective chart review was conducted for adult patients (age ≥18 years) with X(T) ≥15 prism diopter (PD) who underwent strabismus surgery by a single surgeon. Inclusion criteria were 1) corrected VA ≥20/40 in either eye; 2) monocular occlusion at least 30 minutes before deviation measurement; 3) difference of ≤10 PD between near and distance deviation; 4) absence of significant A or V pattern or vertical deviation; 5) lateral rectus recession and medial rectus resection procedure were performed unilaterally; and 6) intended surgical number for deviation correction was aimed at 5 PD undercorrection.Results: Of 234 patients who met the inclusion criteria, 122 were women (52.14%). Average age at the time of surgery was 27.56 years (range, 18–42 years). A total number of 197 patients (84.19%) had postoperative exodeviation under 10 PD. Twenty five (10.68%) and 12 patients (5.13%) had postoperative exodeviation within 10–15 PD and >15 PD, respectively. All patients who had postoperative exodeviation >15 PD exhibited initial deviation of ≥40 PD and had undergone re-operation. In 74 patients (46.25%) out of 160 who had no binocular vision in orthoptic examination before surgery, fusion or stereopsis was gained after good alignment. No postoperative diplopia was found in this study.Conclusion: Intended undercorrection in surgical management of adult X(T) showed good functional and cosmetic outcomes. No procedure resulted in consecutive esodeviation or persistent diplopia. Fusion or stereopsis could be gained after successful surgical alignment. Our recommendations are as follows: 5 PD undercorrection if deviation is <40 PD and regular correction if deviation is ≥40 PD. Keywords: diplopia, intermittent exotropia, stereopsis, fusion, recession, resectionLekskul ASupakitvilekarn TPadungkiatsagul TDove Medical PressarticleDiplopiaIntermittent exotropiaStereopsisFusionRecessionResectionOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1763-1767 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diplopia Intermittent exotropia Stereopsis Fusion Recession Resection Ophthalmology RE1-994
spellingShingle	Diplopia Intermittent exotropia Stereopsis Fusion Recession Resection Ophthalmology RE1-994 Lekskul A Supakitvilekarn T Padungkiatsagul T Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
description	Apatsa Lekskul, Tatha Supakitvilekarn, Tanyatuth Padungkiatsagul Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Purpose: To study the surgical outcomes of intended undercorrection on adult intermittent exotropia (X(T)) performed to avoid postopertively overcorrected diplopia.Patients and methods: A retrospective chart review was conducted for adult patients (age ≥18 years) with X(T) ≥15 prism diopter (PD) who underwent strabismus surgery by a single surgeon. Inclusion criteria were 1) corrected VA ≥20/40 in either eye; 2) monocular occlusion at least 30 minutes before deviation measurement; 3) difference of ≤10 PD between near and distance deviation; 4) absence of significant A or V pattern or vertical deviation; 5) lateral rectus recession and medial rectus resection procedure were performed unilaterally; and 6) intended surgical number for deviation correction was aimed at 5 PD undercorrection.Results: Of 234 patients who met the inclusion criteria, 122 were women (52.14%). Average age at the time of surgery was 27.56 years (range, 18–42 years). A total number of 197 patients (84.19%) had postoperative exodeviation under 10 PD. Twenty five (10.68%) and 12 patients (5.13%) had postoperative exodeviation within 10–15 PD and >15 PD, respectively. All patients who had postoperative exodeviation >15 PD exhibited initial deviation of ≥40 PD and had undergone re-operation. In 74 patients (46.25%) out of 160 who had no binocular vision in orthoptic examination before surgery, fusion or stereopsis was gained after good alignment. No postoperative diplopia was found in this study.Conclusion: Intended undercorrection in surgical management of adult X(T) showed good functional and cosmetic outcomes. No procedure resulted in consecutive esodeviation or persistent diplopia. Fusion or stereopsis could be gained after successful surgical alignment. Our recommendations are as follows: 5 PD undercorrection if deviation is <40 PD and regular correction if deviation is ≥40 PD. Keywords: diplopia, intermittent exotropia, stereopsis, fusion, recession, resection
format	article
author	Lekskul A Supakitvilekarn T Padungkiatsagul T
author_facet	Lekskul A Supakitvilekarn T Padungkiatsagul T
author_sort	Lekskul A
title	Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
title_short	Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
title_full	Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
title_fullStr	Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
title_full_unstemmed	Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
title_sort	outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/520985bdf20843a89b59e6eabd767023
work_keys_str_mv	AT lekskula outcomesofundercorrectioninsurgicalmanagementandbinocularvisiongainedofadultintermittentexotropia AT supakitvilekarnt outcomesofundercorrectioninsurgicalmanagementandbinocularvisiongainedofadultintermittentexotropia AT padungkiatsagult outcomesofundercorrectioninsurgicalmanagementandbinocularvisiongainedofadultintermittentexotropia
_version_	1718403615627935744

Outcomes of undercorrection in surgical management and binocular vision gained of adult intermittent exotropia

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