1.Factors determining the outcome of paediatric exotropia surgery
Ivan Lai Yoon Ki ; Ting Siew Leng ; Cheah Whye Lian ; Sunder Ramasamy ; Jamalia Binti Rahmat
The Medical Journal of Malaysia 2019;74(4):266-269
Objective: To determine the socio-demographic and clinical
profile of exotropia surgery outcomes amongst paediatric
patients.
Methods: This is a descriptive, retrospective, clinical study
of surgeries performed between 2014 and 2016 at the
Sarawak Heart Centre, Malaysia. Medical records of patients
with primary and secondary exotropia were reviewed. The
following factors that affected the surgical outcomes were
collected: onset age of squint, age at the time of surgery, the
interval between diagnosis and surgery, the type of
exotropia, visual acuity, presence of amblyopia, previous
patching, anisometropia, refractive error, type of surgery,
preoperative and postoperative deviation, pre-existing
ocular comorbidity and systemic illness.
Result: A total of 15 patients were studied with more than
two thirds being females. Seven patients had primary
exotropia while eight patients had secondary exotropia.
Average interval between diagnosis and surgery was 1.3
years (±0.82) for primary exotropia and 1.2 years (±0.84) for
secondary exotropia. Average pre-operative angle for
primary exotropia was 50.57PD (±10.83) whereas secondary
exotropia was 39.38PD (±8.63). Seven patients had
successful surgical outcomes of within 10 prism dioptres,
five for primary exotropia and two for secondary exotropia.
The response to surgery was 3.0PD/mm (±0.59) for primary
exotropia and 2.2PD/mm (±0.74) for secondary exotropia.
Conclusion: In our study, primary exotropia had larger
preoperative angle than secondary exotropia. The response
to surgery was positively correlated with the preoperative
angle of deviation. Primary exotropia showed better surgical
outcome.