Outcomes of surgical correction of exotropia in children between 4 to 12 years of age

Abstract

Purpose: This study aims to analyze the outcomes of surgical correction of exotropia in children between 4 to 12 years of age; and the factors associated with favorable surgical outcomes. Methods: In this prospective observational study, the surgical outcomes of 87 patients between 4 and 12 years of age, who underwent correction for primary exotropia (XT), by a single surgeon, were analyzed at 24 months. Results: Out of the total 87 patients, 46 (52.87%) were female and 41 (47.13%) were male. The mean age at surgery was 8.83 ± 3.26 years (range 4–12 years). There was a statistically significant reduction in preoperative prism bar cover test (PBCT), with PBCT at day: 1, 1 month, 6 months, 12 months, and 24 months after surgery (P = 0.00, ANOVA). Among the 42 patients analyzed for near stereoacuity (NSA), the change between preoperative and 24 months NSA was not statistically significant (P = 0.55, Chi-square test). Preoperative PBCT for distance was found to be a significant parameter associated with successful motor alignment at 24 months (P = 0.02, logistic regression). Other variables such as gender, age at surgery, preoperative best-corrected visual acuity, preoperative refractive status, and laterality of surgery were not significantly associated with successful motor alignment at 24 months. Conclusions: Surgical correction of exotropia in children between 4 to 12 years shows satisfactory ocular alignment at 24 months; although there was no significant improvement in NSA in the subgroup analyzed. The preoperative ocular deviation was the only significant factor associated with successful motor outcome at 24 months after surgery.