exotropia surgery risks

October 12th, 2020 by

-. Its prevalence is estimated at 4%–27%. Comparison of recurrent esotropia and consecutive exotropia with horizontal muscle reoperation in infantile esotropia. Consecutive exotropia after correction of hyperopia, Spontaneous consecutive exotropia in childhood, Clinical risk factors for the development of consecutive exotropia: a comparative clinical study, Characteristics and surgical outcomes of consecutive exotropia of different etiologies. The postoperative changes of angle of deviation were calculated. When the patients had not been initially operated in our centre, all efforts were made to know which procedure had been performed to treat the esotropia. -, J AAPOS. Hyperopia was considered significant when ≥4.00 D and anisometropia when ≥1.00 D. The following features were reported: age, gender, age of onset of esotropia, age of esotropia surgery, number of surgeries and chosen procedures, the refractive anomalies (significant hyperopia or anisometropia), an adduction deficit, a convergence insufficiency, a vertical deviation or oblique dysfunction, time of relapse, that is, the time between the esotropia surgery and the consecutive exotropia onset, angle of exodeviation (in PD). The authors declare no substantial contribution provided by another person, no assistance of medical writing experts, no participating authors who would not meet the full authorship criteria.

In adults who develop strabismus, double vision sometimes occurs because the brain has already been trained to receive images from both eyes and cannot ignore the image from the turned eye.
Ophthalmologe. The incidence of the consecutive exotropia seems to increase in studies with a long-term follow-up.9,21 The retrospective design of our series allowed including patients with established consecutive exotropia who underwent their esotropia surgery more than 20 years ago. Some of us advocate early surgery, whereas others advocate waiting as long as possible. Using linear mixed model analysis, the exotropic shift across time was higher in the consecutive exotropia group relative to the controls (P < 0.001). We are asking our website visitors to consent to the use of cookies by HealthTap to continue to our website. Instead of the eyes focusing together on the near object, one deviates outward. Epub 2018 Apr 18.

Seventy-four patients, 24 males and 50 females, were included, of mean (range) age of 33 years (3–66). This site needs JavaScript to work properly. If left untreated, the eye may turn out continually, causing a loss of binocular vision. Clipboard, Search History, and several other advanced features are temporarily unavailable. “The surgery rate of 17 percent was lower than what most of us think of as the number of kids who need surgery. The angle of deviation of consecutive exotropia was ≤20 prism dioptres (PD) in 39%, 21-40 PD in 39% and ≥ 40 PD in 22%, related to amblyopia (p = 0.028), and to high hypermetropia (p = 0.05). The patients were considered as amblyopic when they presented either a difference of two lines or more between the eyes (named ‘relative’ amblyopia) or a best corrected visual acuity of the weaker eye of less than 20/32 (named ‘deep’ amblyopia). Outcome of a surgical treatment protocol for late consecutive exotropia following bilateral medial rectus recession for esotropia.

Epub 2017 Sep 1. The proportion of consecutive exotropias immediately caused by the surgery is small hopefully. Generally, exotropia progresses in frequency and duration.

If the position is large enough, it might affect your appearance. J AAPOS. This causes loss of depth perception and binocular vision. McKenzie J, et al "Prevalence and sex differences of psychiatric disorders in young adults who had intermittent exotropia as children" Arch Ophthalmol 2009; 127:743-47. This site uses cookies.

This compartmentalization was suggested by a selective compartmental intramuscular innervation23 and by the contractile changes of the superior and inferior compartments of the medial recti during convergence and adduction efforts.24,25 Moreover, it has been shown that this differential compartmental activity occurred in all extraocular muscles (recti and superior oblique) in vertical ductions in healthy subjects, and that all extraocular muscles contributed to the normal cyclovertical movements.26. doi: 10.1097/MD.0000000000021401. A second procedure had been performed for 20% of patients to correct a residual esodeviation. When is exotropia needed for surgery? Consecutive exotropia may however also spontaneously develop from esotropia, without surgery or botulinum toxin treatment.) 2018 Nov;115(11):961-966. doi: 10.1007/s00347-018-0784-z. When a child requires surgery, the procedure is usually performed before the child attains school age. Clipboard, Search History, and several other advanced features are temporarily unavailable. 33 years experience Ophthalmology. If you do choose surgery, the doctor will cut the muscles that move the eye from side to side. The amblyopia is the cause of poorer fusion forces and of an increased post-operative instability. The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. Several studies assessed the clinical and surgical risk factors for consecutive exodeviations with a high variability of the highlighted contributive factors. [Unilateral combined strabismus surgery to correct esotropia : Video article on recession of the medial rectus muscle and plication of the lateral rectus muscle]. The consecutive exotropia is a divergent ocular deviation which appears secondarily to an esodeviation. Outcomes of bilateral lateral rectus recession in treatment of recurrent exotropia after bilate... Postoperative Esotropia: Initial Overcorrection or Consecutive Esotropia? 108 patients who underwent BMR recession for esotropia between November 1996 and July 2010 were enrolled. 54 patients who required surgery for consecutive exotropia were compared to 54 controls whose angle of deviation showed less than five prism diopters of esotropia at all periods after BMR recession. Factors associated with atypical postoperative drift following surgery for consecutive exotropia. 2004;19(4):201-6.
Author information: (1)Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Gangwon-do, Republic of Korea. 1997 Sep-Oct;34(5):275-8 Inferior oblique recession, associated or not with a horizontal surgery, was performed in 14%. Before Surgery Exotropia After Surgery. Our cohort of 74 patients allowed to highlight some of them and to assess their importance, such as the early onset of esotropia,2 the amblyopia,7–9 the convergence insufficiency,3,10 the adduction deficit,11,12 an asymmetric surgery,8 and the oblique muscles dysfunction.13 We found a strong influence of the amblyopia on the angle of the consecutive exodeviation. Risk factors for consecutive exotropia after esotropia surgery. The surgery cost depends on insurance coverage, and the risks and benefits of surgery vary from person to person.

Two peaks of incidence appeared in our study: 1–5 years and more than 20 years after esotropia surgery.

A comprehensive preoperative motor and sensory assessment should search for poor binocular vision and amblyopia. 2004 Jun;8(3):230-6

Although vision therapy is generally not covered by American health insurance companies, many large insurers such as Aetna[7] have recently begun offering full or partial coverage in response to recent studies. This study of a retrospective cohort was conducted in accordance with the Declaration of Helsinki. 2013 Sep-Oct;50(5):268-73. doi: 10.3928/01913913-20130430-01. Consecutive exotropia is a complication of the surgery of esotropia which might concern as many as one-fourth of our patients. Why am i having trouble reading after exotropia surgery? Wang and Nelson19 proposed a graded unilateral recession of medial rectus for the treatment of small to moderate angle esotropia. Distribution of patients according the time of onset of consecutive exotropia: number of patients for each time frame. Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. The presence of amblyopia before esotropia surgery and DVD correlated with risk of consecutive exotropia. 2003;18(1):35-48; discussion 49-50. Exotropia is a type of strabismus, which is a misalignment of the eyes. Risk factors for consecutive exotropia after esotropia surgery, Analysis of risk factors for consecutive exotropia and review of the literature, Consecutive exotropia following strabismus surgery, Consecutive exotropia after surgical treatment of childhood esotropia: a 40-year follow-up study, Consecutive exotropia: risk factor analysis and management outcomes, Intraoperative findings in consecutive exotropia with and without adduction deficit, Risk factors analysis of consecutive exotropia: oblique muscle overaction may play an important role, Secondary exotropia: a retrospective analysis of matched cases, Origins of strabismus and loss of binocular vision, Dissociated horizontal deviation and accommodative esotropia: treatment options when an eso- and an exodeviation co-exist, Dissociated horizontal deviations (DHD): nomenclature and etiology. When both eyes are properly aligned and aimed at the same target, the visual portion of the brain fuses the forms into a single image. Binocul Vis Strabismus Q. J Pediatr Ophthalmol Strabismus. 2017 Oct;21(5):360-364. doi: 10.1016/j.jaapos.2017.07.201. [Unilateral combined strabismus surgery to correct esotropia : Video article on recession of the medial rectus muscle and plication of the lateral rectus muscle]. It works: Surgery to straighten eyes is a successful procedure that is commonly performed. The brain's ability to see three-dimensional objects depends on proper alignment of the eyes. The age of onset of esotropia was determined for 43 patients (Table 1): infantile esotropia concerned 35% of patients (15 patients), from 3 months to 1 year for 30% (13 patients), and older than 1 year for 35%.

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