Postoperative esotropia: initial overcorrection or consecutive esotropia?

Eur J Ophthalmol 2017; 27(6): 652 - 657

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ejo.5000954

Authors

Jeon, Hyeshin Choi, Heeyoung

Abstract

Purpose

To investigate the length of time required for diagnosing consecutive esotropia rather than initial overcorrection and examine risk factors for persistent postoperative esotropia after intermittent exotropia surgery.

Methods

This is a retrospective case series in a tertiary medical center. Fifty consecutive patients with postoperative esotropia ≥6 prism diopters at 1 week following exotropia surgery, managed with nonsurgical management and followed up for more than 6 months from 2014 to 2015, were included. Patients were allocated to 1 of 2 groups depending on whether the postoperative esotropia was resolved at 1 month after surgery. Patients with ongoing nonsurgical management were reevaluated monthly. Timing that significant resolution occurred was assessed. Clinical characteristics and motor and sensory successes were evaluated at 6 months after surgery.

Results

Thirty-two patients were allocated to group 1 and 18 to group 2. Significant resolution occurred between 1 week and 1 month after surgery. Patients were older and preoperative deviation at distance was larger in group 2 than in group 1 (p = 0.006 and 0.015). A significantly larger proportion of patients in group 2 showed combined vertical deviation (p = 0.019). Motor and sensory success rates were comparable.

Conclusions

When initial postoperative esotropia persists for more than 1 month, it should be regarded as consecutive esotropia. Older age, a larger preoperative deviation, and concurrent vertical deviation are risk factors for persistent postoperative esodeviations. Therefore, more postoperative attention should be given to these patients.

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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