The impact of simultaneous correction of the V pattern on the results of surgical treatment in children with intermittent exotropia
Purpose This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia. Methods The records of 81 pediatric patients who had surgery for intermi...
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| Published in: | Graefe's archive for clinical and experimental ophthalmology Vol. 262; no. 9; pp. 3021 - 3027 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
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01.09.2024
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| ISSN: | 0721-832X, 1435-702X, 1435-702X |
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| Abstract | Purpose
This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia.
Methods
The records of 81 pediatric patients who had surgery for intermittent exotropia and a follow-up of more than 1 year were reviewed retrospectively. They were divided into groups: a concomitant group which underwent only horizontal muscle surgery of bilateral lateral rectus recession and a V pattern group which had additional inferior oblique recession, further separated into two subgroups: ≥ 15 prism diopters (classic V pattern group) and ≥ 10 < 15 prism diopters (sub-V pattern group). The surgical outcome, deviation control, stereoacuity, and postoperative drift were assessed after 3 months and 1 year postoperatively.
Results
Patients with sub-V and classic V pattern intermittent exotropia showed significantly better surgical success rate (
p
= 0.025) and less postoperative drift (
p
= 0.042) than patients without vertical incomitance. One year after surgery, successful surgical outcome was achieved in 83.72% of the vertically incomitant group: 80.76% for the classic V pattern and 88.24% for the sub-V pattern group, while only in 60.53% of nonpattern patients.
Conclusions
Patients operated for intermittent exotropia with a coexistent V pattern have consistently better surgical long-term results than those with only horizontal deviation. Additional inferior oblique recessions in the sub V pattern group provided excellent outcomes with no overcorrections; therefore, surgeons should consider addressing vertical incomitance even when the typical criteria for the V pattern are not met. |
|---|---|
| AbstractList | This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia.PURPOSEThis study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia.The records of 81 pediatric patients who had surgery for intermittent exotropia and a follow-up of more than 1 year were reviewed retrospectively. They were divided into groups: a concomitant group which underwent only horizontal muscle surgery of bilateral lateral rectus recession and a V pattern group which had additional inferior oblique recession, further separated into two subgroups: ≥ 15 prism diopters (classic V pattern group) and ≥ 10 < 15 prism diopters (sub-V pattern group). The surgical outcome, deviation control, stereoacuity, and postoperative drift were assessed after 3 months and 1 year postoperatively.METHODSThe records of 81 pediatric patients who had surgery for intermittent exotropia and a follow-up of more than 1 year were reviewed retrospectively. They were divided into groups: a concomitant group which underwent only horizontal muscle surgery of bilateral lateral rectus recession and a V pattern group which had additional inferior oblique recession, further separated into two subgroups: ≥ 15 prism diopters (classic V pattern group) and ≥ 10 < 15 prism diopters (sub-V pattern group). The surgical outcome, deviation control, stereoacuity, and postoperative drift were assessed after 3 months and 1 year postoperatively.Patients with sub-V and classic V pattern intermittent exotropia showed significantly better surgical success rate (p = 0.025) and less postoperative drift (p = 0.042) than patients without vertical incomitance. One year after surgery, successful surgical outcome was achieved in 83.72% of the vertically incomitant group: 80.76% for the classic V pattern and 88.24% for the sub-V pattern group, while only in 60.53% of nonpattern patients.RESULTSPatients with sub-V and classic V pattern intermittent exotropia showed significantly better surgical success rate (p = 0.025) and less postoperative drift (p = 0.042) than patients without vertical incomitance. One year after surgery, successful surgical outcome was achieved in 83.72% of the vertically incomitant group: 80.76% for the classic V pattern and 88.24% for the sub-V pattern group, while only in 60.53% of nonpattern patients.Patients operated for intermittent exotropia with a coexistent V pattern have consistently better surgical long-term results than those with only horizontal deviation. Additional inferior oblique recessions in the sub V pattern group provided excellent outcomes with no overcorrections; therefore, surgeons should consider addressing vertical incomitance even when the typical criteria for the V pattern are not met.CONCLUSIONSPatients operated for intermittent exotropia with a coexistent V pattern have consistently better surgical long-term results than those with only horizontal deviation. Additional inferior oblique recessions in the sub V pattern group provided excellent outcomes with no overcorrections; therefore, surgeons should consider addressing vertical incomitance even when the typical criteria for the V pattern are not met. PurposeThis study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia.MethodsThe records of 81 pediatric patients who had surgery for intermittent exotropia and a follow-up of more than 1 year were reviewed retrospectively. They were divided into groups: a concomitant group which underwent only horizontal muscle surgery of bilateral lateral rectus recession and a V pattern group which had additional inferior oblique recession, further separated into two subgroups: ≥ 15 prism diopters (classic V pattern group) and ≥ 10 < 15 prism diopters (sub-V pattern group). The surgical outcome, deviation control, stereoacuity, and postoperative drift were assessed after 3 months and 1 year postoperatively.ResultsPatients with sub-V and classic V pattern intermittent exotropia showed significantly better surgical success rate (p = 0.025) and less postoperative drift (p = 0.042) than patients without vertical incomitance. One year after surgery, successful surgical outcome was achieved in 83.72% of the vertically incomitant group: 80.76% for the classic V pattern and 88.24% for the sub-V pattern group, while only in 60.53% of nonpattern patients.ConclusionsPatients operated for intermittent exotropia with a coexistent V pattern have consistently better surgical long-term results than those with only horizontal deviation. Additional inferior oblique recessions in the sub V pattern group provided excellent outcomes with no overcorrections; therefore, surgeons should consider addressing vertical incomitance even when the typical criteria for the V pattern are not met. This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia. The records of 81 pediatric patients who had surgery for intermittent exotropia and a follow-up of more than 1 year were reviewed retrospectively. They were divided into groups: a concomitant group which underwent only horizontal muscle surgery of bilateral lateral rectus recession and a V pattern group which had additional inferior oblique recession, further separated into two subgroups: ≥ 15 prism diopters (classic V pattern group) and ≥ 10 < 15 prism diopters (sub-V pattern group). The surgical outcome, deviation control, stereoacuity, and postoperative drift were assessed after 3 months and 1 year postoperatively. Patients with sub-V and classic V pattern intermittent exotropia showed significantly better surgical success rate (p = 0.025) and less postoperative drift (p = 0.042) than patients without vertical incomitance. One year after surgery, successful surgical outcome was achieved in 83.72% of the vertically incomitant group: 80.76% for the classic V pattern and 88.24% for the sub-V pattern group, while only in 60.53% of nonpattern patients. Patients operated for intermittent exotropia with a coexistent V pattern have consistently better surgical long-term results than those with only horizontal deviation. Additional inferior oblique recessions in the sub V pattern group provided excellent outcomes with no overcorrections; therefore, surgeons should consider addressing vertical incomitance even when the typical criteria for the V pattern are not met. Purpose This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on the results of surgical correction of intermittent exotropia. Methods The records of 81 pediatric patients who had surgery for intermittent exotropia and a follow-up of more than 1 year were reviewed retrospectively. They were divided into groups: a concomitant group which underwent only horizontal muscle surgery of bilateral lateral rectus recession and a V pattern group which had additional inferior oblique recession, further separated into two subgroups: ≥ 15 prism diopters (classic V pattern group) and ≥ 10 < 15 prism diopters (sub-V pattern group). The surgical outcome, deviation control, stereoacuity, and postoperative drift were assessed after 3 months and 1 year postoperatively. Results Patients with sub-V and classic V pattern intermittent exotropia showed significantly better surgical success rate ( p = 0.025) and less postoperative drift ( p = 0.042) than patients without vertical incomitance. One year after surgery, successful surgical outcome was achieved in 83.72% of the vertically incomitant group: 80.76% for the classic V pattern and 88.24% for the sub-V pattern group, while only in 60.53% of nonpattern patients. Conclusions Patients operated for intermittent exotropia with a coexistent V pattern have consistently better surgical long-term results than those with only horizontal deviation. Additional inferior oblique recessions in the sub V pattern group provided excellent outcomes with no overcorrections; therefore, surgeons should consider addressing vertical incomitance even when the typical criteria for the V pattern are not met. |
| Author | Kochana, Malgorzata Rosa, Agnieszka Loba, Piotr |
| Author_xml | – sequence: 1 givenname: Malgorzata orcidid: 0009-0006-6958-6160 surname: Kochana fullname: Kochana, Malgorzata email: mzkochana@gmail.com organization: Ophthalmology Department, Zeromski Specialist Hospital – sequence: 2 givenname: Agnieszka orcidid: 0000-0001-7779-9525 surname: Rosa fullname: Rosa, Agnieszka organization: Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, University Barlicki Hospital No.1, Laser Eye Microsurgery Centre Clinic of Prof. Jerzy Szaflik – sequence: 3 givenname: Piotr orcidid: 0000-0002-2982-4084 surname: Loba fullname: Loba, Piotr organization: Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, University Barlicki Hospital No.1, Laser Eye Microsurgery Centre Clinic of Prof. Jerzy Szaflik |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38597961$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_ajo_2025_08_014 |
| Cites_doi | 10.1016/s0021-5155(00)00351-8 10.3341/jkos.2011.52.7.846 10.3928/0191-3913-19940701-06 10.1080/09273970802020292 10.1177/11206721221090795 10.1016/j.jaapos.2008.06.001 10.1016/j.jaapos.2010.06.007 10.1097/MD.0000000000002590 10.1016/j.jcjo.2020.01.009 10.1080/09273970600894716 10.1001/archophthalmol.2010.88 10.1016/j.ajo.2012.07.011 10.1016/s0161-6420(89)32774-6 10.1371/journal.pone.0179626 10.1001/archopht.1969.00990020205010 10.1016/j.jaapos.2008.10.013 10.1016/j.jfo.2020.09.038 10.1371/journal.pone.0162819 10.4103/tjo.tjo_44_17 10.1038/eye.2014.270 10.1136/bmjophth-2018-000243 10.1016/j.ophtha.2018.08.034 |
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| Keywords | Intermittent exotropia Strabismus surgery V pattern Vertical incomitance |
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This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V... This study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V pattern on... PurposeThis study is to investigate the impact of the coexistence of basic intermittent exotropia and vertical incomitance in the form of the V and sub-V... |
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| SubjectTerms | Adolescent Child Child, Preschool Coexistence Drift Exotropia - physiopathology Exotropia - surgery Eye Movements - physiology Female Follow-Up Studies Humans Male Medicine Medicine & Public Health Oculomotor Muscles - physiopathology Oculomotor Muscles - surgery Ophthalmologic Surgical Procedures - methods Ophthalmology Patients Pediatrics Retrospective Studies Surgery Surgical outcomes Treatment Outcome Vision, Binocular - physiology Visual Acuity - physiology |
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