Factors Affecting the Surgical Outcome of Primary Exotropia in Children

Objective: The objective of current study to evaluate the outcome results of the surgical correction and as well as the effects of some factors on the outcome and surgical response of primary exotropia.

Study Design: Retrospective Clinical Study.

Place and Duration of Study: Hamad Medical Corporation –Tertiary Hospital in Qatar, study done over six months.

Methods: Medical records of patients who underwent surgical correction of primary exotropia procedures between the years 2008 and 2013 were retrospectively reviewed. Patients less than 15 years of age were included in the study and the following data were collected: onset age of squint, age at surgery, type of exotropia, visual acuity, presence of amblyopia, anisometropia, refractive error (spherical equivalent), preoperative deviation, AV pattern, stereopsis, type of surgery and analysis using descriptive statistics, unpaired t- and chi-square statistical tests.

Results: Of 74 patients we studied, 30 Male (40.5%), 44 Female (59.5%), 46 patients (62.2%) had successful surgical outcome, and 28 patients (37.8%) had unsuccessful outcome (all under correction). The response to surgery correlated mainly to with the preoperative angle. A higher response resulted from larger preoperative deviation and it this was better with lateral plus medial rectus muscle recessions than with bilateral lateral rectus recession.

Conclusions: Preoperative deviation was the most important factor in determining better response to surgical correction of primary exotropia, and accurate measurement of the angle of deviation can improve the outcome and response to surgery.