Journal of the Korean Ophthalmological Society 2007;48(2):321-327.
Published online February 28, 2007.
The Clinical Analysis after Reoperation for Recurrent Intermittent Exotropia.
Sang Jin Kim, Dong Gyu Choi
Department of Ophthalmology, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea. eyechoi@dreamwiz.com
재발된 간헐외사시로 재수술한 환자의 임상분석
김상진,최동규
Department of Ophthalmology, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
Correspondence:  Sang Jin Kim, M.D.
Abstract
PURPOSE
To analyze the clinical course and relationships between the factors and surgical outcomes after reoperation for recurrent intermittent exotropia. METHODS: Surgical results were retrospectively investigated in 38 patients who had undergone reoperation at least 3 months after surgical correction. Recurrence was defined as an exodeviation of more than 10 prism diopters at the primary position. We investigated the recurrence rate according to the follow-up duration with survival analysis, and analyzed the relationships between the factors and surgical outcome. RESULTS: The mean survival period was 22.7+/-20.2 months (range, 3 to 72 months). As the follow-up duration increased, the recurrence rate progressively increased. The hazard ratio for recurrence of a unilateral medial rectus resection as a reoperation was significantly higher than that for a unilateral lateral rectus recession and medial rectus resection (recession and resection)(p=0.021). After using unilateral recession and resection as the primary surgery, the hazard ratio for recurrence of unilateral recession and resection as a reoperation was not significantly different from that for unilateral lateral rectus recession (p=0.480). After a bilateral lateral rectus recession, the hazard ratio for recurrence of unilateral medial rectus resection was not significantly different from that for bilateral medial rectus resection (p=0.076). CONCLUSIONS: The surgical options for recurrent intermittent exotropia are contralateral recession and resection or contralateral lateral rectus recession. The procedure chosen depends on the operator's preference after performing unilateral recession and resection as the primary surgery. After a bilateral lateral rectus recession, the hazard ratio for recurrence of unilateral medial rectus resection was not significantly higher than that for a bilateral medial rectus resection, but even so, a bilateral medial rectus resection may be more effective than unilateral medial rectus resection for recurrent intermittent exotropia.
Key Words: Intermittent exotropia;Recurrent exotropia;Recurrent intermittent exotropia;Reoperation;Strabismus surgery


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