J Korean Ophthalmol Soc > Volume 58(6); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(6):692-697.
DOI: https://doi.org/10.3341/jkos.2017.58.6.692    Published online June 15, 2017.
Factors Associated with Improved Surgical Outcomes in Recurrent Exotropia.
Min Jung Kim, Seung Hyun Kim
Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea. ansaneye@hanmail.net
재발외사시 수술 성공률 향상을 위한 인자 분석
고려대학교 의과대학 안과학교실
Correspondence:  Seung Hyun Kim,
Email: ansaneye@hanmail.net
Received: 23 June 2016   • Revised: 10 October 2016   • Accepted: 2 February 2017
To investigate the factors that improve the success rate in patients with recurrent exotropia. METHODS: A total of 60 patients who had undergone reoperation for recurrent exotropia and had at least 1 year of follow-up after surgery were included in this study. In total, 43 patients in the group with one-muscle surgery had undergone either unilateral medial rectus resection or unilateral lateral rectus recession, and the other 17 patients in the group with two-muscle surgery had undergone either bilateral medial rectus resection or lateral rectus muscle recession with medial rectus muscle resection of contralateral eye. The main outcome measure was final success rate, which was compared between the 2 groups. RESULTS: In this study, 41 (95.3%) of 43 patients in the group with one-muscle surgery had successful outcomes, while 2 (4.7%) had undercorrection at the final follow-up examination. On the other hand, 10 (58.8%) of 17 patients in the group with two-muscle surgery had successful outcomes, 5 (29.4%) had undercorrection, and 2 (11.8%) had overcorrection. The success rates were significantly different between the 2 groups (p = 0.001). In addition, preoperative deviation had the largest area under the receiver operator characteristic (ROC) curve for the success rate and exhibited an optimal balance of both sensitivity and specificity using a cut-off value of 25 PD. CONCLUSIONS: Final success rate was higher in the group with one-muscle surgery for the treatment of recurrent exotropia. Surgical outcomes are expected to be higher in patients with preoperative deviation of less than 25 PD.
Key Words: Intermittent exotropia;Recurrent exotropia;Reoperation;Success rate

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