Strabismus最新文献

{"title":"Test retest variability in stereoacuity measurements.","authors":"Jignasa Mehta, Anna O'Connor","doi":"10.1080/09273972.2023.2252853","DOIUrl":"10.1080/09273972.2023.2252853","url":null,"abstract":"<p><p><i>Background</i>: A clinician's choice of stereotest is influenced by the robustness of the measurement, in terms of sensitivity, specificity and test-retest variability. In relation to the latter aspect, there are limited data on the test-retest variability of these new tests and how they compare to the more commonly used stereotests. Therefore, the aim of the study was to determine the test-retest variability of four different measures of stereoacuity (TNO, Frisby, Lang Stereopad and Asteroid (Accurate STEReotest On a mobIle Device)) and to compare the stereoacuity measurements between the tests in an adult population. <i>Methods</i>: Stereoacuity was measured twice using TNO, Frisby, Lang Stereopad and Asteroid. Inclusion criteria included adult participants (18 years and older), no known ophthalmic condition and VA (Visual Acuity) equal to or better than 0.3 logMAR (Logarithm of the Minimum Angle of Resolution) with interocular difference of less than 0.2 logMAR. Bland-Altman analysis was used to assess agreement within and between stereotests. Differences in stereo thresholds were compared using signed Wilcoxon tests. <i>Results</i>: Fifty-four adults (male: 23 and female: 31) with VA equal to or better than 0.3 logMAR in either eye and interocular difference less than 0.2 logMAR were assessed (mean age: 38 years, SD: 12.7, range: 18-72). The test-retest variability of all the clinical stereotests, with the exception of the Lang Stereopad (<i>p</i> = .03, Wilcoxon signed-rank test), was clinically insignificant as the mean bias was equal or less than 0.06 log seconds of arc (equivalent to 1.15 seconds of arc). While the Asteroid test had the smallest variation between repeated measures (mean bias: -0.01 log seconds of arc), the Frisby and Lang Stereopad tests had the narrowest and widest limits of agreement respectively. When comparing results between tests, the biggest mean bias was between Frisby and Lang Stereopad (-0.62 log seconds of arc), and 64.8% and 31.5% of differences were in the medium (21-100\" of arc) and larger (>100\" of arc) ranges respectively. <i>Conclusion</i>: The TNO and Frisby tests have good reliability but measure stereoacuity over a narrower range compared to the Asteroid which shows less variation on repeated testing but has a larger testing range. The data reported here show varying degrees of agreement in a cohort of visually normal participants, and further investigation is required to determine if there is further variability when stereoacuity is reduced.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"188-196"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229975","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":"A population-level post-screening treatment cost framework to help inform vision screening choices for children under the age of seven.","authors":"Anna Horwood, Eveline Heijnsdijk, Jan Kik, Frea Sloot, Jill Carlton, Helen J Griffiths, Huibert J Simonsz","doi":"10.1080/09273972.2023.2268128","DOIUrl":"10.1080/09273972.2023.2268128","url":null,"abstract":"<p><strong>Purpose/background: </strong>Visual acuity (VA) screening in children primarily detects low VA and amblyopia between 3 and 6 years of age. Photoscreening is a low-cost, lower-expertise alternative which can be carried out on younger children and looks instead for refractive amblyopia risk factors so that early glasses may prevent or mitigate the conditions. The long-term benefits and costs of providing many children with glasses in an attempt to avoid development of amblyopia for some of them needs clarification. This paper presents a framework for modeling potential post-referral costs of different screening models once referred children reach specialist services.</p><p><strong>Methods: </strong>The EUSCREEN Screening Cost-Effectiveness Model was used together with published literature to estimate referral rates and case mix of referrals from different screening modalities (photoscreening and VA screening at 2, 3-4 years and 4-5 years). UK 2019-20 published National Health Service (NHS) costings were used across all scenarios to model the comparative post-referral costs to the point of discharge from specialist services. Potential costs were compared between a) orthoptist, b) state funded ophthalmologist and c) private ophthalmologist care.</p><p><strong>Results: </strong>Earlier VA screening and photoscreening yield higher numbers of referrals because of lower sensitivity and specificity for disease, and a different case mix, compared to later VA screening. Photoscreening referrals are a mixture of reduced VA caused by amblyopia and refractive error, and children with amblyopia risk factors, most of which are treated with glasses. Costs relate mainly to the secondary care providers and the number of visits per child. Treatment by an ophthalmologist of a referral at 2 years of age can be more than x10 more expensive than an orthoptist service receiving referrals at 5 years, but outcomes can still be good from referrals aged 5.</p><p><strong>Conclusions: </strong>All children should be screened for amblyopia and low vision before the age of 6. Very early detection of amblyopia refractive risk factors may prevent or mitigate amblyopia for some affected children, but population-level outcomes from a single high-quality VA screening at 4-5 years can also be very good. Total patient-journey costs incurred by earlier detection and treatment are much higher than if screening is carried out later because younger children need more professional input before discharge, so early screening is less cost-effective in the long term. Population coverage, local healthcare models, local case-mix, public health awareness, training, data monitoring and audit are critical factors to consider when planning, evaluating, or changing any screening programme.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"220-235"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693791","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":"Comparison between bupivacaine injection and mini-tenotomy in the management of horizontal small angle strabismus in children.","authors":"Wahj N Al-Saeed, Hala M Elhilali, Ahmed M Kamal, Rania S Mohammad, Rasha H Zedan","doi":"10.1080/09273972.2023.2248196","DOIUrl":"10.1080/09273972.2023.2248196","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcome of bupivacaine (BUP) injection vs mini-tenotomy of extra-ocular muscles in treating small angle horizontal strabismus in children.</p><p><strong>Methods: </strong>A prospective comparative study that included a total of 40 patients. Twenty patients received 3 ml of 0.75% Bupivacaine (BUP) injection in both medial recti in case of exotropia and in both lateral recti in case of esotropia. MRI orbit was performed before and 30-60 days' post injection of bupivacaine to estimate changes in muscle size. Mini-tenotomy was done in the other 20 patients, performed on both lateral recti in case of exotropia and on both medial recti in case of esotropia.</p><p><strong>Results: </strong>Mean change of alignment at the end of 6 months in exotropic patients in bupivacaine group was 5.50 ± 4.10 PD and in esotropia patients 4.00 ± 3.38 PD with an average increase in muscle thickness of 0.12 mm ± 0.08 and 0.13 mm ± 0.09 in exotropia and esotropia, respectively. There was an average increase in volume 23 mm³ ± 17.3 and 17.00 mm³ ± 9.50 in exotropia and esotropia, respectively, as measured with MRI. The mean change of alignment in mini-tenotomy was 5.33 ± 4.12 PD, 5.75 ± 4.95 PD in exotropia and esotropia, respectively.</p><p><strong>Conclusion: </strong>Bupivacaine and mini-tenotomy are safe and effective alternative treatment, that improved eye alignment in 65% of patients with small angle horizontal deviation.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"172-181"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202098","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":"A pilot randomized clinical trial comparing muscle transplant versus hang back recession in extra-large angle exotropia.","authors":"Amar Pujari, Sujeeth Modaboyina, Rajeswari Thangavel, Deeksha Rani, Sudarshan K Khokhar","doi":"10.1080/09273972.2023.2239299","DOIUrl":"10.1080/09273972.2023.2239299","url":null,"abstract":"<p><strong>Purpose: </strong>For extra-large angle exotropia (>60 prism diopters, PD), single-setting surgical alternatives are scarce; frequently, more than two muscle or two eye procedures are indicated. To evaluate the viability of single eye surgery, a current randomized comparative trial is undertaken.</p><p><strong>Methods: </strong>Twenty adult patients with extra-large angle exotropia underwent a thorough orthoptic evaluation before being divided into two groups at random. Ten patients in group 1 underwent medial rectus resection (5.5-7.5 mm), followed by transplant-aided lateral rectus recession (effective length: 4-5.5 mm) (9 mm). In group two, ten different patients underwent medial rectus resection (5.5-7 mm), but this time, the lateral rectus recession (9 mm) was aided with a hang-back suture (5-7 mm). The two procedures were compared at baseline and six months post-operatively.</p><p><strong>Results: </strong>There was no significant difference in the groups' median ages (<i>P</i> = .95). In groups one and two, the median corrections achieved were 81.00 (79.50-85.50) PD and 81.00 (79.75-86.50) PD, respectively. The differences in corrections were statistically insignificant (<i>p</i> = .99). In all patients, abduction limitation was frequently noted in the immediate post-operative period, which improved over time. In each group, there were two patients (>90 prisms) with residual deviation of at least 30 PD, for which the contralateral eyes were operated.</p><p><strong>Conclusions: </strong>The hang-back recession was as successful as muscle transplant procedure in correcting 80-90 PD of exotropia with notable clinical benefits and ease.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"159-165"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925201","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":"Comparison of current paediatric contrast sensitivity assessments using simulated reduced contrast thresholds.","authors":"Paula Amores Morillo, Ashli Milling, Anna O'Connor","doi":"10.1080/09273972.2023.2250393","DOIUrl":"10.1080/09273972.2023.2250393","url":null,"abstract":"<p><strong>Purpose: </strong>There are limited tests of contrast sensitivity (CS) for use in children. The Hiding Heidi (HH) is suitable for all cognitive abilities, but has a ceiling effect. The Double Happy (DH) test has comparable thresholds to the Pelli Robson (PR), however the ability to detect changes in contrast has not been established. This study aims to compare contrast thresholds and agreement between HH and the DH, comparing to the PR chart in normal conditions and under reduced visual and lighting conditions.</p><p><strong>Methods: </strong>Tests were repeated under different conditions to reduce the contrast. Room illumination was 20,900{plus minus}2% lux in bright conditions and 2,000{plus minus}2% lux in dim conditions, both conditions were repeated with the addition of simulation spectacles to reduce the clarity of vision. Participants' CS was measured uniocularly using the PR, HH and DH tests.</p><p><strong>Results: </strong>50 participants, age 18-62 years (mean{plus minus}standard deviation: 24.5{plus minus}7.98), were assessed. On HH 94% (<i>n</i> = 47) reached the maximum score, with the DH it was 18% (<i>n</i> = 9). The difference in reduction between conditions was smaller with HH in comparison to PR and DH, but significantly different from baseline conditions. Under dim conditions the reduction in PR and DH was -0.21 logCS units, but only -0.04 logCS for HH.</p><p><strong>Conclusion: </strong>The DH test has better agreement with PR than HH and is better at detecting CS changes, highlighting the advantages of use in clinical practice.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"182-187"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106226","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":"Pulled-in-two syndrome in strabismus surgery for congenital fibrosis of the extraocular muscles.","authors":"Didem Dizdar Yigit,&nbsp;Aslı İnal,&nbsp;Ceren Gürez,&nbsp;Birsen Gokyigit","doi":"10.1080/09273972.2023.2231032","DOIUrl":"10.1080/09273972.2023.2231032","url":null,"abstract":"<p><p><i>Purpose:</i> The aim of this study is to present six cases of pulled-in-two syndrome (PITS) in strabismus surgeries and to discuss our prevention and management strategies. <i>Methods:</i> This is a retrospective study presenting cases of PITS during strabismus operations. The medical records of the subjects who underwent operation in the strabismus unit of Beyoglu Eye Training and Research Hospital were reviewed retrospectively, from January 2000 till March 2022. Detailed ophthalmological examination records and angle of deviation were noted. <i>Results:</i> A total of six cases (four males and two females) with a mean age of 37.2 ± 28.0 (min 9-max 71) years were included in this study. All of the cases had congenital fibrosis of extraocular muscles (CFEOM). The most commonly involved muscle was medial rectus (83%). Majority of cases (67%) were adults. In all cases, the muscle was found and reattached to the globe. No patients had diplopia after surgery. <i>Conclusion:</i> PITS is a rare complication that can be seen during strabismus surgeries, and CFEOM patients are in the risk group. Therefore, surgeons should be cautious and prepared in risky patients to be able to manage this complication.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"135-138"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274166","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":"EEG changes as an indication of central nervous system involvement following cyclopentolate 1% eye drops; a randomized placebo-controlled pilot study in a pediatric population.","authors":"Helena Maria van Minderhout, Maurits Victor Joosse, Erica Surya Klaassen, Nicoline Elisabeth Schalij-Delfos","doi":"10.1080/09273972.2023.2218455","DOIUrl":"10.1080/09273972.2023.2218455","url":null,"abstract":"<p><p>To compare EEG-patterns after instillation of cyclopentolate versus placebo eye drops. Prospective, randomized, placebo-controlled, and observational pilot study is presented. Ophthalmology outpatient clinic Dutch metropolitan hospital. Healthy 6- to 15-year-old volunteers with normal or low BMI requiring a cycloplegic refraction/retinoscopy. Randomized; 1 visit 2 drops cyclopentolate-1% and 1 visit 2 drops placebo (saline-0.9%). Single-blind: conducting researcher. Double blind: subjects, parents, clinical-neurophysiology staff, neurologist, and statistician. A 10-min baseline EEG-recording, drop-application, and follow-up to at least 45 min. Primary outcome: Detection of CNS changes, i.e. EEG-pattern changes, following two drops of cyclopentolate-1%. Secondary outcome: Determination of the extent of these pattern changes. Thirty-six cyclopentolate-1% saline-0.9% EEG registrations were made in 33 subjects;  18 males and 15 females. Three subjects were tested twice (interval 7 months). Nine out of fourteen (64%) of the 11- to 15-year-old children reported impaired memory, attention, alertness, as well as mind wandering following cyclopentolate. Drowsiness and sleep were seen in EEG-recordings of 11 subjects (33%) following cyclopentolate. We observed no drowsiness nor sleep during placebo recordings. The mean time to drowsiness was 23 min. Nine subjects arrived in stage-3 sleep but none arrived in REM-sleep. In subjects without sleep (N=24), significant changes compared to placebo-EEG were present for many leads and parameters. The main findings during awake eye-open recording were as follows: 1) a significant increase of temporal Beta-1,2 and 3-power, and 2) a significant decrease in: a) the parietal and occipital Alpha-2-power, b) the frontal Delta-1-power, c) the frontal total power, and d) the occipital and parietal activation synchrony index. The former finding reflects cyclopentolate uptake in the CNS, and the latter findings provide evidence for CNS suppression. Cyclopentolate-1% eye drops can affect the CNS and may cause altered consciousness, drowsiness, and sleep with concomitant EEG results in both young children and children in puberty. There is evidence that cyclopentolate has the potency to act as a short acting CNS depressant. Nevertheless, however, cyclopentolate-1% can safely be used in children and young adolescents.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"82-96"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640001","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":"Evaluation of <i>Strabocheck®</i> as an objective measurement method of comitant horizontal strabismus in children undergoing surgery.","authors":"Casem Azri,&nbsp;Pierre Tomietto,&nbsp;Emmanuel Marciano,&nbsp;Emmanuel Bui-Quoc","doi":"10.1080/09273972.2023.2204886","DOIUrl":"10.1080/09273972.2023.2204886","url":null,"abstract":"<p><p>The gold standard of angle measurement is the prism alternating cover test (PCT). This method requires cooperation from the child, experience, and presents a significant inter-observer variability. <i>Strabocheck®</i>(SK) is a new simple tool for objective and semi-automated angle measurement. Our purpose is to evaluate <i>Strabocheck®</i> in children undergoing surgery for comitant horizontal strabismus. The study population was divided into 3 groups: infantile esotropia, partially accommodative esotropia and intermittent exotropia. The primary endpoint was the agreement between <i>Strabocheck®</i>and the PCT. A total of 44 children were included prospectively. The correlation between the angle measured by the PCT and the angle measured by SK was strong (<i>R</i> = 0.87). The mean absolute difference in the angle measured by the two methods was Δ = 11.9+/- 9.8 diopters. The Bland-Altman plot shows a 95% interval limit between -30.0 [-34.4; -25.6] and 31.0 [26.7; 35.4] diopters. SK is an interesting tool to evaluate the angle of strabismus in children. However, the residual discordance between PCT and SK leads us to question the real value of the angle, which can only be approximated. A better clinical experience of this new tool in relation to the clinical condition and the PCT will allow to have a more accurate idea on the true angle and will probably help the surgeon to adapt this procedure.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"73-81"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9484553","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":"Early post-operative angle as a predictor of surgical success in adult patients with intermittent exotropia.","authors":"Akshay Narayan,&nbsp;Surinder Dosanjh,&nbsp;Jonathan Dominic,&nbsp;Saurabh Jain","doi":"10.1080/09273972.2023.2234406","DOIUrl":"10.1080/09273972.2023.2234406","url":null,"abstract":"<p><p><i>Purpose</i>: Intermittent exotropia is a condition where divergent strabismus is present at certain times or fixation distances and is surgically treated with bilateral lateral rectus recession or unilateral lateral rectus recession with medial rectus resection. The main purpose of our study is to assess the relationship between the initial post-operative deviation and surgical outcomes in adult exotropes undergoing recess-resect surgery. <i>Methods</i>: A retrospective chart review was performed on adult patients who underwent unilateral recess-resect surgery for intermittent exotropia between March 2010 and February 2022 at a single institution with at least 3 months of follow-up. Based on their motor alignment at 2 weeks following surgery, they were categorized as having exodeviation, esodeviation within 10 PD and esodeviation exceeding 10 PD. Surgical success was defined as motor alignment within 10 PD of exotropia and 5 PD of esotropia at distance and near at final follow-up. <i>Results</i>: 93 patients were included, 55% female and average age was 37 years. At postoperative week 2, 26 patients demonstrated residual exodeviation (Group A), 53 patients demonstrated an esodeviation of within 10 PD (Group B) and 14 patients demonstrated an esodeviation greater than 10 PD (Group C). There were no significant differences in pre-operative and demographic factors between the group. At the final follow-up, surgical success was observed in 57 patients: 12 in Group A, 41 in Group B and 4 in Group C (<i>P</i> < .01). <i>Conclusion</i>: Overcorrection of within 10 PD at 2 weeks following surgery showed a more favorable surgical outcome compared to exodeviation or esodeviation exceeding 10 PD.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"152-158"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9777334","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":"Predictors and efficacy of surgical treatment for consecutive exotropia.","authors":"Pilar Merino,&nbsp;Alvaro Mata,&nbsp;Nuria Díaz,&nbsp;Pilar Gomez de Liaño,&nbsp;Jacobo Yáñez-Merino","doi":"10.1080/09273972.2023.2228369","DOIUrl":"10.1080/09273972.2023.2228369","url":null,"abstract":"<p><strong>Purpose: </strong>To study the surgical outcomes of consecutive exotropia and predictive factors, and to compare the medial rectus (MR) advancement, lateral rectus (LR) recession, or a combination of both procedures.</p><p><strong>Methods: </strong>A retrospective study of patients diagnosed with consecutive exotropia that were operated on (2000-2020) were included. The convergence was classified from 0 to +++, with good: ++/+++ and poor: 0/+. A good outcome was considered when the final horizontal deviation was < 10 prism diopters (pd). Follow-up since the surgery and the number of reoperations were registered.</p><p><strong>Results: </strong>A total of 88 cases were analyzed, mean age: 33.98 ± 17.68 years (57.95%: women). The near and distance horizontal deviation mean (±SD) was 34.3 pd (±16.45) and 34.36 pd (±16.33), respectively. MR advancement was performed in 36.36%, LR recession in 27.27%, and a combination of both in 36.36%. Surgery was unilateral in 65.91% (bilateral in 34.09%). A good outcome was obtained in 69.32% and reoperations in 11.36%. The insufficiency convergence was associated with a bad outcome. The near horizontal deviation (<i>P</i> = .006), the vertical deviation (VD) association (<i>P</i> = .036) and the combination of both MR advancement and LR recession (<i>P</i> = .017) were predictors of a bad result. The mean follow-up was 56.5 months ± 57.65.</p><p><strong>Conclusion: </strong>A long-term good surgical result was obtained in most patients. The greatest near deviation, the VD association, and the combination of MR advancement and the LR recession were predictive factors for bad results.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"129-134"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10055508","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}