Strabismus最新文献

{"title":"Medial-lateral rectus union for long standing complete third nerve palsy: a prospective interventional study from a tertiary eye care centre.","authors":"Swarna Nishu, Vaishali Tomar, Mittali Khurana, Subhash Dadeya, Shivani Kumari, Aarushi Saini, Padma Chorol","doi":"10.1080/09273972.2026.2736871","DOIUrl":"https://doi.org/10.1080/09273972.2026.2736871","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the surgical outcomes of medial rectus (MR) and lateral rectus (LR) union in patients with long-standing complete third nerve palsy, with respect to changes in ocular alignment and extraocular motility.</p><p><strong>Methods: </strong>This prospective interventional study included 11 patients aged 18-60 years with non-resolving complete third nerve palsy of more than six months' duration. Patients with partial palsy, multiple cranial nerve palsies, or previous ocular surgery were excluded. All patients underwent MR-LR union, involving longitudinal splitting of the LR into superior and inferior halves, passage of each half beneath the corresponding vertical rectus muscle, and union with the split anterior segment of the MR, while the remaining posterior MR segment was reattached to its original scleral insertion. The primary outcome measure was improvement in ocular alignment. Surgical success was defined as a postoperative residual horizontal deviation of ≤10 prism diopters (PD) and a residual vertical deviation of ≤5 PD in primary position. Secondary outcome measures included changes in ocular motility. Postoperative follow-up was performed until three months.</p><p><strong>Results: </strong>    The mean preoperative horizontal deviation decreased significantly from 70.45 ± 13.87 PD to 26.36 ± 12.06 PD at three months postoperatively (Friedman test, <i>p</i> < .001). Vertical deviation decreased from 45.91 ± 13.00 PD to 39.09 ± 12.00 PD, without statistical significance (<i>p</i> = .934). Adduction improved significantly from -3.82 ± 0.40 to -2.27 ± 0.65 (<i>p</i> < .001), accompanied by reduced abduction from 0.00 to -1.73 ± 0.79 (<i>p</i> < .001). Surgical success was achieved in one patient (9.1%).</p><p><strong>Conclusion: </strong>MR-LR union is a technically feasible procedure that produces significant improvement in horizontal alignment in patients with long-standing complete third nerve palsy. However, vertical correction is limited when performed in isolation, particularly in patients with large baseline vertical deviations. No major complications were observed in this limited prospective series; however, larger studies with longer follow-up are required before definitive conclusions regarding procedural safety can be drawn.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of anterior nasal transposition in inferior oblique overaction grades +3 and +4: a randomized controlled trial.","authors":"Amira Alattier, Ghada Hassan Allam, Mohammed Elashri, Manal Kasem, Mohamed Ahmed Hafez","doi":"10.1080/09273972.2026.2726814","DOIUrl":"https://doi.org/10.1080/09273972.2026.2726814","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical approach for high-grade inferior oblique muscle overaction (IOOA) remains controversial. Both anterior nasal transposition (ANT) and conventional anterior transposition (ATIO) are used to correct this condition. We aimed to compare the efficacy, postoperative stability, and safety of ANT with ATIO for the treatment of high-grade IOOA.</p><p><strong>Methods: </strong>This is a randomized controlled trial on patients with high-grade (+3 or +4) IOOA who were randomly assigned to either the ANT or ATIO group. Primary outcomes included changes in vertical deviation and postoperative grade of IOOA. Secondary outcomes included V-pattern correction, torsional changes, surgical success at 6 months, and postoperative complications.</p><p><strong>Results: </strong>A total of 30 patients were enrolled and equally allocated to the two groups. Both groups were demographically and preoperatively comparable. The ANT group demonstrated a significantly greater reduction in postoperative hypertropia compared to the ATIO group that remained stable throughout the follow-up period at 1 week (8.4 ± 3.2 vs. 6.8 ± 2.9Δ, <i>p</i> = .042), 1 month (7.6 ± 3.5 vs. 5.2 ± 2.7Δ, <i>p</i> = .008), 3 months (7.3 ± 3.7 vs. 4.9 ± 2.8Δ, <i>p</i> = .003), and 6 months (7.2 ± 3.8 vs. 4.1 ± 2.9Δ, <i>p</i> = .001). Both procedures were highly effective in correcting IOOA, with no significant difference in the final IOOA grade between the two groups. The complication rates were similar for both procedures with no statistically significant differences.</p><p><strong>Conclusion: </strong>Both ATIO and ANT are effective for the management of high-grade IOOA (grades +3 and +4). However, ANT may provide a greater reduction in postoperative hypertropia without increasing complication rates.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of trypan blue in identifying damaged extraocular muscles in orbital trauma: a case report.","authors":"Karin C Takatsu, Mariza Polati, Breno M Magalhães, Roberta M B Zagui","doi":"10.1080/09273972.2026.2729326","DOIUrl":"https://doi.org/10.1080/09273972.2026.2729326","url":null,"abstract":"<p><strong>Purpose: </strong>Complete rupture or avulsion of an extraocular muscle after orbital trauma is rare, and intraoperative identification of the retracted muscle stump may be difficult when the surgical field is distorted by hemorrhage and edema. Trypan blue 0.1% is a vital dye that stains muscle sheaths and tendons without staining sclera or muscle fibers, and has been described in strabismus reoperations and lost-muscle recovery. Its use during acute exploratory surgery for orbital trauma has not, to our knowledge, been reported.</p><p><strong>Methods: </strong>We report a 30-year-old woman who presented with binocular vertical diplopia three days after blunt trauma to the right eye during a syncopal fall. Examination showed right hypertropia in primary position with a -3 limitation of depression. Orbital computed tomography showed no fracture but suggested discontinuity of the inferior rectus muscle belly. Same-day exploratory surgery was performed under general anesthesia, with intraoperative application of 0.1% trypan blue.</p><p><strong>Results: </strong>Exploration revealed complete laceration of the inferior rectus 6 mm from its insertion, with the distal stump adherent to Tenon's capsule and Lockwood's ligament in a field distorted by hemorrhage and edema. Trypan blue selectively stained the muscle sheaths, allowing the distal inferior rectus stump to be distinguished from surrounding connective tissue, and disclosed an additional partial avulsion of the temporal portion of the inferior oblique not identified on computed tomography. The proximal stump of the inferior rectus was resected and the distal stump reinserted 6.5 mm from the limbus with 6-0 polyglactin sutures. At last follow-up, three months after surgery, she reported no diplopia in primary position, upgaze or downgaze, with good alignment in primary position and mild residual limitation of depression and abduction of the right eye.</p><p><strong>Discussion: </strong>The dye altered intraoperative management in two ways: it confirmed the identity of the distal inferior rectus stump before reinsertion, in a field where torn muscle and hemorrhagic connective tissue were not reliably distinguishable by inspection; and it disclosed injury to the inferior oblique, the landmark conventionally used to locate a retracted inferior rectus. Trypan blue is not required in every case of orbital trauma. It may, however, be a useful adjunct in selected acute explorations where tissue planes are obscured and conventional landmarks are themselves injured.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Brown's syndrome with Parry-Romberg syndrome: frozen gaze and fading face.","authors":"Vaishali Tomar, Purva Verma, Shivani Kumari, Padma Chorol, Neha Garg, Subhash Dadeya","doi":"10.1080/09273972.2026.2732089","DOIUrl":"https://doi.org/10.1080/09273972.2026.2732089","url":null,"abstract":"<p><p><i>Purpose:</i> We report a rare case of bilateral Brown's syndrome associated with Parry-Romberg Syndrome (PRS), highlighting this rare syndromic association and its possible shared pathophysiology. <i>Methods:</i> An 8-year-old female presented with longstanding right-eye inward deviation and decreased vision in the right eye. Ocular examination revealed bilateral limitation of elevation in adduction, consistent with Brown's syndrome. Systemic findings included progressive right-sided facial atrophy, preauricular skin anomalies, and dental abnormalities. Imaging and laboratory investigations confirmed PRS. Surgical management and ongoing follow-up outcomes were documented. <i>Results:</i> Forced duction testing demonstrated bilateral superior oblique tightness. Imaging revealed generalized extraocular muscle atrophy with relative fibrosis of the superior obliques. The patient underwent right eye superior oblique tenotomy and 5 mm medial rectus recession under general anesthesia. Postoperatively, ocular alignment improved significantly, with residual 5 prism diopters of hypotropia in primary gaze. Multidisciplinary evaluation confirmed PRS, and amblyopia therapy was initiated with ongoing follow up for progressive facial changes. <i>Conclusion:</i> This is a rare reported case of bilateral Brown's syndrome associated with PRS. This case broadens the ophthalmic spectrum of PRS and suggests a potential link between progressive hemifacial atrophy and restrictive strabismus patterns. Comprehensive ophthalmic and systemic evaluation is essential in such complex presentations.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":0.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monocular and binocular vision function following patching alone versus combined patching and active vision therapy in non-strabismic refractive amblyopia.","authors":"Santosh Chhetri, Aashish Kant Shah, Umesh Belbase, Dikshya Khadka, Hari Bahadur Thapa, Mario Cantó Cerdán","doi":"10.1080/09273972.2026.2726816","DOIUrl":"https://doi.org/10.1080/09273972.2026.2726816","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate binocular visual function in amblyopic patients who achieved optimal visual acuity following treatment with either conventional patching alone or combined patching and structured Active vision therapy (AVT).</p><p><strong>Methods: </strong>This retrospective chart review included 67 patients with non strabismic refractive amblyopia (31 patching; 36 combined treatment) who achieved best-corrected visual acuity (BCVA) ≤0.17 logMAR in both eyes after treatment. The combined treatment consisted of patching with structured active vision therapy incorporating anti-suppression, accommodative, vergence, and visuomotor exercises. Post-treatment assessment included stereoacuity (log seconds of arc), vergence parameters (phoria, near point of convergence, fusional vergence), accommodative lag, accommodative facility (monocular and binocular), and binocular sensory status. Within-group changes were analyzed using Wilcoxon signed-rank tests; between-group comparisons were performed using Mann-Whitney U tests. Effect sizes (r) were calculated for intergroup comparisons.</p><p><strong>Results: </strong>Both groups demonstrated significant reduction in accommodative lag (<i>p</i> < .001). Post-treatment stereoacuity was significantly better in the combined treatment group (<i>p</i> < .001; <i>r</i> = 0.724). The combined treatment group also showed superior vergence function, with larger positive fusional vergence amplitudes (<i>r</i> = 0.60) and improved near point of convergence (<i>r</i> = 0.488). Monocular and binocular accommodative facility were significantly higher in the combined treatment group (<i>r</i> = 0.656 and <i>r</i> = 0.690, respectively). Treatment duration was significantly shorter in the combined treatment group (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>Combined patching and structured AVT group was associated with superior binocular vision function outcomes and reduced treatment duration. However, due to the non-randomized, retrospective design of the study, findings should be interpreted with caution. AVT is a more intensive treatment requiring greater motivation, adherence, supervision, and access to care.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-15"},"PeriodicalIF":0.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An enduring classic revisited: a comparative study of standard vs. augmented FINK techniques in V-pattern correction.","authors":"Ana Letícia Fornazieri Darcie, Roberta Melissa Benetti Zagui, Mariza Polati, Allan Christian Pieroni Goncalves","doi":"10.1080/09273972.2025.2601859","DOIUrl":"10.1080/09273972.2025.2601859","url":null,"abstract":"<p><p><i>Purpose:</i> To compare the efficacy of the original and augmented Fink techniques in the surgical correction of V-pattern strabismus associated with primary inferior oblique overaction. <i>Methods:</i> We conducted a retrospective chart review of patients who underwent concurrent horizontal strabismus surgery (recess - resect procedure) and bilateral symmetric inferior oblique recession using either the standard Fink technique (corresponding to an 8-mm recession) or augmented variants (9, 10, or 11-mm recession). The primary outcome assessed was reduction in V-pattern strabismus, measured in prism diopters (PD) using prism and alternate cover testing in primary position,upgaze, and downgaze. <i>Results:</i>  Twenty-nine patients were studied. Ten underwent the standard Fink procedure with bilateral 8-mm recessions. The remaining patients received augmented recessions: 8 patients with 1 mm (9 mm total), 2 patients with 2 mm (10 mm total), and 9 patients with 3 mm (11 mm total) beyond Fink's original point. Greater inferior oblique recession correlated with larger postoperative reduction of V-pattern strabismus. The 11-mm group achieved the greatest correction, significantly more than the 8-mm (<i>p</i> = .002) and 9-mm groups (<i>p</i> = .018). The 9-mm group showed more variability in outcomes, while the 10-mm group had intermediate corrections but limited by a small sample size (<i>n</i> = 2). <i>Conclusions:</i> Augmenting the Fink technique by placing the inferior oblique insertion more inferiorly enhances correction of V-pattern strabismus, especially with 11-mm recessions, without causing significant anteriorization. These findings indicate that progressive augmentations can be customized based on the severity of the V-pattern. Larger, prospective studies are needed to validate these findings and refine surgical protocols.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"296-300"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of fusional vergences in adults with heterophoria using synoptophore and prism bar.","authors":"Vishal Biswas, Roshni Majumder, Supriya Awasthi","doi":"10.1080/09273972.2025.2593528","DOIUrl":"10.1080/09273972.2025.2593528","url":null,"abstract":"<p><p><i>Purpose:</i> The aim of the study was to compare the amplitudes of negative and positive fusional vergences in exophoria and esophoria using a synoptophore and prism bar. <i>Methods</i>: A prospective study was conducted from May to July 2024 among university students. In participants with mild to moderate heterophoria, horizontal fusional vergence amplitudes (blur, break and recovery points) were assessed for distance using prism bar and synoptophore. Consistent testing conditions and standardized procedures were maintained. Data were analyzed using SPSS v26 with the Wilcoxon signed-rank test. <i>p</i> values less than 0.05 were considered as statistically significant. To assess the level of difference between values from synoptophore and prism bar, descriptive statistics was used across heterophoria grades. <i>Results</i>: A total of 60 participants were divided into mild (<10 PD) and moderate (>10-20 PD) exophoria and esophoria groups (<i>n</i> = 15 each). The values obtained from synoptophore yielded consistently higher fusional vergences than prism bar. In mild exophoria, the synoptophore had small, but statistically significant higher negative fusional vergence break point (11.8 ± 1.15 PD) than the prism bar (10.53 ± 1.55 PD, <i>p</i> < .05), as with the positive fusional vergence break (17.27 ± 1.75 PD vs. 15.4 ± 1.71 PD, <i>p</i> < .05). In mild esophoria, the synoptophore had a greater positive fusional vergence break (23.33 ± 1.05 PD) compared to the prism bar (22.33 ± 1.05 PD, <i>p</i> < .05). For moderate deviations, higher values for blur, break and recovery points were seen with the values obtained from synoptophore in both positive and negative fusional vergence. <i>Conclusion</i>: The negative and positive fusional vergences were higher when measured with the synoptophore than the prism bar in both mild and moderate deviations, consistent with earlier research and reinforcing the need for further studies to establish clinical relevance.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"279-287"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial transposition of the split lateral rectus muscle used as a primary procedure for treatment of complete third nerve palsy.","authors":"Mohamed F Farid","doi":"10.1080/09273972.2025.2607743","DOIUrl":"10.1080/09273972.2025.2607743","url":null,"abstract":"<p><p><i>Purpose</i>: This case series aims to study the effect of medial transposition of the split lateral rectus (MTSLR) muscle used as a primary procedure for surgical management of complete third nerve palsy. <i>Methods</i>: A retrospective review of all cases with complete third nerve palsy which underwent surgical intervention in a tertiary care center from 2019 to 2023 was undertaken, and only cases underwent isolated MTSLR as a primary procedure were included. Data collection included age, etiology, laterality, follow-up, preoperative and postoperative deviation, and postoperative complications. <i>Results</i>: A total of 12 patients (14 eyes) were identified, and mean follow-up after surgery was 15.4 months (range; 7-37 months). Mean age at time of surgery was 34.5 years (range; 2-65 years). Right eye was involved in 5 patients, left eye in 5 patients, while two cases were bilateral. Surgical success (within 10PD of orthotropia) was achieved in all patients. Mean primary gaze exotropia (XT) improved from 96.2PD before surgery (range; 60-130 PD) to 1.8PD after surgery (range; 6PD ET to 8PD XT) (<i>p</i> ˂ .0001). Mean primary position Hypotropia, which was present in 5 cases only, improved from 4.2PD (range 5-14PD) to 0.7PD (range 0-4PD). Abduction significantly declined from a mean of 0 to -3.9 postoperatively, with no significant improvement of limited adduction. No postoperative complications have been encountered, apart from transient postoperative horizontal diplopia in one patient which resolved spontaneously. <i>Conclusion</i>: MTSLR muscle attains long term acceptable aesthetic results and functional alignment when used as a primary procedure for treatment of complete oculomotor nerve palsy, with low rate of postoperative complications.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"301-307"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strabismus surgery outcomes in pediatric patients with developmental delay: a meta-analysis and systematic review.","authors":"Edward Tran, Monali Malvankar-Mehta, Nirmit Shah, Sapna Sharan","doi":"10.1080/09273972.2026.2637559","DOIUrl":"10.1080/09273972.2026.2637559","url":null,"abstract":"<p><p><i>Purpose</i>: Strabismus management in developmental-delayed children presents challenges, as outcomes are unpredictable due to factors such as limited neuroplasticity, poor central control, and subnormal binocular potential. This meta-analysis evaluates the outcomes of strabismus surgery in these children. <i>Methods</i>: Eligible studies published before 28 May 2023 were extracted from MEDLINE, EMBASE, CINAHL, Cochrane, PsychINFO, and gray literature. A meta-analysis was performed using STATA 14.0. The comparator group were children without developmental delays who underwent strabismus surgery. Fixed-effect and random-effect models were computed based on heterogeneity. <i>Results</i>: Our meta-analysis included 31 articles, with a total of 3687 subjects. There was no significant difference in the surgical dose for children with developmental delays compared to children without developmental delays (SMD -0.06, 95% CI: [-0.36, 0.23]). Post-operatively, developmentally delayed children had a significant improvement in their angle of deviation (SMD 2.79, 95% CI: [2.50, 3.08]) and could achieve a post-operative angle of deviation similar to children without developmental delays (SMD -0.20, 95% CI: [-0.51, 0.11]). The median rate of undercorrection was similar between developmentally delayed and children without developmental delays, at 20.4% and 20.2%, respectively. For the median rate of overcorrection, developmentally delayed children had a higher rate of 12%, compared to 4.35% in children without developmental delays. For developmentally delayed children, the median incidence is 71.45% for needing one surgery, 23.9% for two surgeries, and 7.15% for three surgeries. <i>Conclusions</i>: Strabismus surgery in developmentally delayed children may have higher rates of overcorrection and may need more repeat operations but could achieve significant improvements in their ocular alignment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"389-404"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk factors increasing the recurrence of intermittent exotropia following surgery.","authors":"Tuğba Göncü Fırat, Murat Keskin, Nurşen Öncel Acır, Burcu Taşkıran Kandeğer","doi":"10.1080/09273972.2025.2589238","DOIUrl":"10.1080/09273972.2025.2589238","url":null,"abstract":"<p><p><i>Purpose</i>: To evaluate the factors and preoperative clinical features associated with recurrence after surgical correction of intermittent exotropia (IXT). <i>Methods</i>: The medical files of patients who underwent surgery for IXT at a single center between July 2021 and June 2024 were retrospectively reviewed. Final motor success was defined as ocular alignment within 10 prism diopters (PD) of exodeviation to 5 PD of esodeviation at both distance and near. Recurrence was defined as a postoperative deviation greater than 10 PD at distance and near during follow-up. Factors evaluated included age at surgery, duration between symptom onset and surgery, preoperative angle of deviation, stereoacuity, binocular fusion, spherical equivalent, type of surgery, presence of amblyopia, fixation preference and other associated strabismic features. The relationship between these factors with and recurrence was analyzed. <i>Result</i>: A total of 58 patients (34 male, 58.5%) were included. The mean age was 21.2 ± 11.7years, and the mean follow-up was 12.3 ± 5.3months. Forty-one patients underwent bilateral lateral rectus recession, three underwent unilateral lateral rectus recession with medial rectus resection, and 14 underwent combined operation, bilateral lateral rectus recession with oblique muscle - weakening procedures. Surgical success at final visit was achieved in 34 (58.6%). There was no relation between recurrence and the type of intermittent exotropia in patients, sex, age at surgery, family history, consanguinity, amblyopia, anisometropia, abnormal ocular motility, fixation preference, binocular function, or surgical method (<i>p</i> >.05). However, a long duration of exotropia and high preoperative deviations at both distance and near were found to be related to postoperative recurrence. <i>Conclusions</i>: The overall surgical success rate in this study was 58.6%. Moreover, longer duration of preoperative exodeviation and larger preoperative deviation at both distance and near were identified as significant risk factors for postoperative recurrence.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"347-353"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}