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Clinical science

The relationship between preoperative and postoperative near stereoacuities and surgical outcomes in intermittent exotropia Dae Seung Lee, Seong-Joon Kim, Young Suk Yu Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea Correspondence to Dr Seong-Joon Kim, Department of Ophthalmology, Seoul National University College of Medicine, #103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea; [email protected] Received 30 December 2013 Revised 10 April 2014 Accepted 15 April 2014 Published Online First 13 May 2014

ABSTRACT Aims To classify patients with intermittent exotropia (IXT) according to the level of near stereopsis, evaluate postoperative stereoacuity and assess the surgical outcomes among groups. Methods The records of 137 patients with IXT were reviewed. Patients were divided into three groups based on the degree of stereopsis: good (40–60 arcsec), moderate (80–200 arcsec) and poor (>200 arcsec). These groups were compared with each other with respect to preoperative and postoperative clinical features. Results Poor stereopsis was found in 19 (13.9%) patients, moderate in 62 (45.2%) and good in 56 (40.9%) patients. There were no statistically significant differences among groups in the mean preoperative and postoperative exodeviations or in the rate of successful surgery. The preoperative and postoperative stereoscopic statuses were similar in each group. Patients with better stereopsis tended to be older when the IXT was first detected and showed better best-corrected visual acuity than those with poorer stereopsis ( p=0.027, 0.005, respectively). Conclusions Classification of IXT based on the degree of near stereopsis offers a useful tool for the assessment of initial sensory status as well as postoperative prognosis. Also, a lower age at first detection of IXT and a lower best-corrected visual acuity were associated with poor near stereoacuity.

INTRODUCTION

To cite: Lee DS, Kim S-J, Yu YS. Br J Ophthalmol 2014;98:1398–1403. 1398

Numerous researchers have investigated the relationship between intermittent exotropia (IXT) and stereopsis. Patients with IXT typically exhibit bifoveal fixation and normal near stereoacuity.1–3 However, some patients with IXT exhibit reduced near stereoacuity.4 A recent cohort study demonstrated the deterioration of near stereopsis in children with IXT.5 There are also a number of reports about the effect of strabismus surgery on stereopsis in patients with IXT. Some studies have demonstrated improved distance stereoacuity after invervention.6 7 The patients with XT who achieved superior sensory outcomes were those with motor realignment before age 7 years, strabismus duration of

The relationship between preoperative and postoperative near stereoacuities and surgical outcomes in intermittent exotropia.

To classify patients with intermittent exotropia (IXT) according to the level of near stereopsis, evaluate postoperative stereoacuity and assess the s...
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