We analyzed preoperative clinical characteristics, incidence of amblyopia, surgical results according to the type, resolution of preoperative symptoms and postoperative complications in 62 patients with intermittent exotropia, who were more than 15 years of age. The most frequent preoperative annoying symptom was eye strain from fatigue(40%), and the next one was cosmesis(23%). But, diplopia(14%) was relatively infrequent presenting complaint. Among 62 patients, 45 (72%) patients had equal vision, and 11 patients (18%) had amblyopia with two line difference between two eyes. The overall surgical success rate were seventy-seven percent. The 3 patients with postoperative esodeviation more than 5 prism diopters(PD) showed persistent uncrossed diplopia. The 4 patients with undercorrection more than 15 PD did not improve symptomatically. All patients with` postoperative exodeviation less than 15 PD had improvement or resolution of the symptoms. Our results suggest that overcorrection often resulted in unexpected diplopia in adults with intermittent exotropia. Therefore, it may be desirable to make undercorrection within 15 PD or orthotropic state in the patients more than 15 years of age.
Adult ; Amblyopia ; Diplopia ; Esotropia ; Exotropia* ; Humans ; Incidence ; Postoperative Complications

We analyzed the surgical results of 9 eyes in 7 patients who had undergone the anterior transposition of inferior oblique muscle for correction of dissociated vertical deviation(DVD) with inferior oblique overaction from April, 1990 to February, 1992. The follow up periods were at least more than 6 months. In cases of upward deviation angle were less than 16 delta, we have done transposition of the inferior oblique muscle to just temporal insertion of inferior rectus muscle, and in cases of upward deviation angle were more than 16 delta, the inferior oblique muscle was transpositioned to 1mm anterior position of the just temporal insertion of inferior rectus muscle. Average reduction of DVD in method A(5 eyes in 4 patients) was 9.2 delta, average reduction of DVD in method B(4 eyes in 3 patients) was 10.2 delta. As for postoperative complications, mild upgaze limitation was observed in all cases and one case of "V" pattern exotropia and one case of protrusion of lower eyelid were observed at extreme upgaze position. Therefore, anterior transposition of inferior oblique muscle for correction of dissociated vertical deviation(DVD) with inferior oblique overact ion can considered as a good method to remove the postoperative manifest vertical deviation.
Exotropia ; Eyelids ; Follow-Up Studies ; Humans ; Postoperative Complications

The purpose of this study is to evaluate retrospectively the surgical results and complications in the patients with unilateral superior oblique palsy using superior oblique plication(SO plication) only or SO plication combined with inferior oblique weakening. Among 22 patients with unilateral superior oblique palsy, there were 13 patients(59.1%) in type III, 5 patients(22.7%) in type IV, 2 patients(9.1%) in type II and 2 patients(9.1%) in type V according to Knapps classification. The mean amount of hypertropia was 18 prism diopters(PD) and 18 of 22 patients(81.8%) showed abnormal head posture(AHP). Nineteen patients (86.4%) showed horizontal strabismus and exotropia was most common. The methods of oblique and vertical rectus operation were SO plication, SO plication combined with inferior oblique weakening, combined with resection of inferior rectus, and combined with recession of contralateral inferior rectus, inferior oblique weakening, and superior rectus weakening. We performed corrective surgery on the patients with horizontal deviation more than 14 PD. Postoperatively the mean amount of hypertropia was 2.6PD. In 7 patients with superior oblique plication only the mean amount of correction in plication was 8.4PD, and hypertropia was corrected 1.2PD per mm. Thirteen of 18 patients(72.2%) with AHP and 15 of 19 patients (78.9%) with horizontal strabismus were corrected after operation. Postoperative complications were residual hypertropia in 7 patients(31.8%) and Brown syndrome in one. We conclude that plication of the superior oblique may be one of the effective procedures for correction of superior oblique palsy and possible its complications may be postoperative undercorrection and Brown syndrom.
Classification ; Exotropia ; Head ; Humans ; Paralysis ; Postoperative Complications ; Retrospective Studies ; Strabismus

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia.
Exotropia/*complications/*surgery ; Humans ; Male ; Middle Aged ; Oculomotor Muscles/*surgery ; Strabismus/*complications/*surgery ; Treatment Outcome

Intermittent Exotropia has been treated by various surgical methods such as bilateral medial rectus resection, lateral rectus recession and medial rectus resection of deviating eye, and bilateral lateral rectus recession. However, the outcomes of such operations are unsatisfactory because of high incidence of postoperative undercorrection and overcorrection. Authors have performed a surgical method which is the medial rectus muscle resection of dominant eye and lateral rectus muscle recession of non-dominant eye in 68 patients. Authors considered the outcome successful if patients achieve deviation between 10 PD of exophoria and 5 PD of esophoria, good stereopsis, no suppression and no manifest deviation. The success rate was 83.8% (57/68) and there was no overcorrection over 6 months follow-up. As postoperative complications, 5 cases of temporary turning of face and 3 cases of asymmetric palpebral fissure were seen. Therefore, these results suggest that medial rectus resection of dominant eye and lateral rectus recession of non-dominant eye in intermittent exotropia may be an alternative surgical method for intermittent exotropia. However, further studies are necessary to determine the exact surgical amounts and mechanism of this surgical method.
Depth Perception ; Esotropia ; Exotropia* ; Follow-Up Studies ; Humans ; Incidence ; Postoperative Complications

PURPOSE: To investigate and compare the clinical courses and surgical success rates of secondary operations in recurrent exotropia according to the type of first operation for correction of exotropia. METHODS: A retrospective chart review was performed for all patients with recurrent exotropia of the basic or pseudodivergence excess types. In group A (36 patients), bilateral lateral rectus (LR) recession was performed as the first operation and uni- or bilateral medial rectus (MR) resection was performed as the second operation. In group B (19 patients), unilateral LR recession-MR resection (R&R) was performed as the first operation and LR recession or R&R in contralateral eye as the second operation. RESULTS: There were no significant differences between the 2 groups when considering age at each operation, frequency of the amblyopia, prescription of prism, time interval for recurrence and reoperation and the final and cumulative success rates. No postoperative complications were observed in either group. The mean number of used muscles for the first and second operation was 3.9 +/- 0.4 in group A, and 3.4 +/- 0.5 in group B (p = 0.001). Mean time interval for occurrence of postoperative orthophoria was 3.7 +/- 6.2 months in group A and 6.5 +/- 16.2 in group B (p = 0.047). In group B, the incidence of esodeviation tended to increase after postoperative 1 month. CONCLUSIONS: The final success rates of reoperation between the 2 types of the first operation in recurrent exotropia were similar. Mean time between postoperative overcorrection of orthophoria was shorter in the group with bilateral LR recession followed by secondary MR resection than in the other group. Unilateral R&R followed by LR recession or R&R in contralateral eye may be more helpful to decrease the number of used muscles than in the bilateral LR recession followed by secondary MR resection.
Amblyopia ; Esotropia ; Exotropia* ; Humans ; Incidence ; Muscles ; Postoperative Complications ; Prescriptions ; Recurrence ; Reoperation* ; Retrospective Studies

PURPOSE: To investigate and compare the clinical courses and surgical success rates of secondary operations in recurrent exotropia according to the type of first operation for correction of exotropia. METHODS: A retrospective chart review was performed for all patients with recurrent exotropia of the basic or pseudodivergence excess types. In group A (36 patients), bilateral lateral rectus (LR) recession was performed as the first operation and uni- or bilateral medial rectus (MR) resection was performed as the second operation. In group B (19 patients), unilateral LR recession-MR resection (R&R) was performed as the first operation and LR recession or R&R in contralateral eye as the second operation. RESULTS: There were no significant differences between the 2 groups when considering age at each operation, frequency of the amblyopia, prescription of prism, time interval for recurrence and reoperation and the final and cumulative success rates. No postoperative complications were observed in either group. The mean number of used muscles for the first and second operation was 3.9 +/- 0.4 in group A, and 3.4 +/- 0.5 in group B (p = 0.001). Mean time interval for occurrence of postoperative orthophoria was 3.7 +/- 6.2 months in group A and 6.5 +/- 16.2 in group B (p = 0.047). In group B, the incidence of esodeviation tended to increase after postoperative 1 month. CONCLUSIONS: The final success rates of reoperation between the 2 types of the first operation in recurrent exotropia were similar. Mean time between postoperative overcorrection of orthophoria was shorter in the group with bilateral LR recession followed by secondary MR resection than in the other group. Unilateral R&R followed by LR recession or R&R in contralateral eye may be more helpful to decrease the number of used muscles than in the bilateral LR recession followed by secondary MR resection.
Amblyopia ; Esotropia ; Exotropia* ; Humans ; Incidence ; Muscles ; Postoperative Complications ; Prescriptions ; Recurrence ; Reoperation* ; Retrospective Studies

PURPOSE: To describe the clinical features of Duane's retraction syndrome (DRS) in Korean patients. METHODS: We retrospectively analyzed the 78 DRS cases that presented to our department between 1995 and 2004. The clinical features investigated included sex distribution, laterality, type of presentation, deviation in primary position, anomalous vertical movements, face turn, amblyopia and anisometropia. RESULTS: There were 38 (48.7%) affected males and 40 (51.3%) females. Left eye predominance (83.3%) was observed, as was type I presentation (85.9%). Orthotropia was found to be the most common primary position in 46 cases (59.0%). Face turn in unilateral DRS was noted in 13 patients (17.1%). There were 6 cases (7.7%) with anisometropia and 4 (5.1%) with amblyopia. CONCLUSIONS: The clinical manifestations of DRS in our study were different from those of equivalent Caucasian studies yet similar to those previously reported for Asian groups. Racial and regional differences were noted, for which further research is needed to elaborate the reasons and mechanisms.
Adolescent ; Adult ; *Asian Continental Ancestry Group ; Child ; Child, Preschool ; Duane Retraction Syndrome/*complications/ethnology/*physiopathology ; Esotropia/*complications ; Exotropia/*complications ; Female ; Humans ; Male ; Retrospective Studies

PURPOSE: To evaluate the efficacy of tattooing with tissue marking dye for cosmetic repair of corneal opacity. METHODS: Tattooing by the injection of tissue marking dye into the corneal stroma was performed in 67 eyes of 67 patients in whom there were no changes in visual acuity or size of corneal opacity for at least 5 years. Conjunctivalized corneal opacities and calcium deposits were removed before tattooing. All patients were followed up for a period of at least 3 months. RESULTS: The most common causes of corneal opacity were trauma (56.6%) and infectious disease (19.4%). Combined ocular diseases included sensory exotropia (43.3%) and band keratopathy (31.3%). In this study, 98.5% of patients showed satisfactory results with cosmetic staining. Remaining opacity was observed in 1 eye (1.5%). Intraoperative complications occurred in 6 eyes (9.0%) and were resolved completely during surgery. Foreign body sensations (38.8%) and conjunctival injection (32.8%) disappeared within 2 months after surgery. CONCLUSIONS: Cosmetic repair by tattooing using tissue marking dye is an effective treatment for corneal opacity and is not associated with any significant complications.
Calcium ; Communicable Diseases ; Corneal Opacity* ; Corneal Stroma ; Exotropia ; Foreign Bodies ; Humans ; Intraoperative Complications ; Sensation ; Tattooing* ; Visual Acuity

The changes of higher-order aberrations (HOAs) after bilateral lateral rectus muscle recession were evaluated. Forty eyes of 20 children were enrolled and their wavefront information was assessed until postoperative 3 months. Even though the root mean square (RMS) of total aberration was not changed, the RMS of HOA was transiently increased at postoperative 1 week and returned to baseline level after 1 month. Among individual Zernike coefficient, secondary astigmatism, quadrafoil, secondary coma, secondary trefoil, and pentafoil showed similar tendency with the RMS of HOA. However, coma, trefoil, and spherical aberration were not changed. Regarding recession amount, it did not correlate with any Zernike coefficient. In summary, our data imply that the HOAs are transiently increased after lateral rectus recession surgery. These results are in collusion with previous reports that strabismus surgery induced transient corneal astigmatism.
Adolescent ; Astigmatism/*etiology ; Child ; Child, Preschool ; Exotropia/*surgery ; Female ; Humans ; Male ; Postoperative Care ; *Postoperative Complications/epidemiology/pathology ; Vision Tests