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Outcomes of surgical management of intermittent exotropia in a paediatric age group—a retrospective study in a multi‐ethnic metropolitan population
Author(s) -
Qadir Muhammed Omar,
ElDefrawy Hany,
AbuAin Mohammad
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.20200263
Subject(s) - exotropia , medicine , esotropia , strabismus , intermittent exotropia , strabismus surgery , population , visual acuity , retrospective cohort study , surgery , ethnic group , refractive error , binocular vision , psychosocial , ophthalmology , psychiatry , environmental health , artificial intelligence , sociology , anthropology , computer science
Purpose Intermittent exotropia is one of the most common types of strabismus in children especially in Asian and South Asian populations. Prevalence of exotropia in this group is estimated to range from 7–18.5× higher than esotropia. Spontaneous resolution is rare and if neglected may lead to loss of Binocular Single Vision (BSV) and negative psychosocial consequences. We aim to evaluate the outcomes of surgical management for intermittent exotropia at a unit in Birmingham (UK), an area unique for its high non‐White ethnic population (43%), majority of who are Asian/South‐Asian. Methods Retrospective case notes review of patients diagnosed with intermittent exotropia who underwent strabismus surgery in 2019–2020 by two surgeons using two different surgical approaches with a 3 month follow‐up. Measures included pre‐ and post‐operative visual acuity and stereopsis, surgical indications, near and distance strabismus angle with refractive correction, type of surgery performed and parental satisfaction at follow‐up. Results Nineteen children underwent surgery during this period with a mean age of 7 range (4–12). Eighteen patients had surgery for functional reasons and one for cosmetic. Two patients recovered BSV where previously Frisby negative, remaining patients maintained BSV. The mean preoperative near and distance exodeviation in prism dioptres (PD) was 30.16 and 34.47, respectively. The mean postoperative near and distance exodeviation was 1.53 PD & 5.16 PD, respectively at 3 months. Two patients developed suture granulomas which resolved with steroid drops post‐operatively. No significant difference between the two surgical techniques was noted. In all cases, parents were satisfied with the results. Conclusions Outcomes in our multi‐ethnic population have been excellent in terms of improvement in exodeviation and maintenance of BSV. Long‐term follow‐up is required to see how many patients will show evidence of recurrence requiring reoperation and whether ethnicity impacts this.