| International FP-005 |
| Incidence and factors predisposing to consecutive esotropia or eye movement limitation after combining inferior oblique muscle weakening procedures with exotropia surgery |
| Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine |
| Woo Beom Shin, Jinu Han, Sueng-Han Han |
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Purpose : To analyse the incidence and factors associated with the onset of consecutive esotropia and limitation of abduction after surgery for intermittent exotropia associated with inferior oblique overaction, and to investigate its clinical course.
Methods : We prospectively recruited of 156 patients who had shown intermittent exotropia associated with inferior oblique overaction. Inferior oblique muscle weakening procedure combined with exotropia surgery were performed to all patients. We evaluated the risk factors for consecutive esotropia, defined as esodeviation ≥10 prism diopters (PD) and limitation of abduction at postoperative month 1 or later. We also evaluated the clinical course of consecutive esotropia and limitation of abduction.
Results : Consecutive esotropia occurred in 4 (2.63%) of 152 patients. Only younger age at surgery (p=0.039) showed significant association with consecutive esotropia. Among 4 patients, 3 became orthophoric without any additional treatment. Limitation of abduction occurred in 7 (4.61%) of 152 patients. Grades of abduction deficit were less than -1. Myopic spherical equivalent (p=0.035) showed significant association with limitation of eye movement. All patients showed complete improvement of the limitation of abduction without any treatment within 7.3 months.
Conclusion : Younger age at surgery was predisposing factors for consecutive esotropia and more myopic spherical equivalent was associated with the cause of the limitation of abduction. However, considering the incidence and its clinical course, combining inferior oblique muscle weakening procedure with exotropia surgery does not seem to increase the risk of consecutive esotropia. Abduction deficit may occur after combined surgery, but the grades were very mild and resolved spontaneously.
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