Monofixational exotropia may be a separate entity from intermittent exotropia

This is a retrospective re-analysis of data from two prospective randomized clinical trials previously published by the author, Burton J. Kushner, MD, on the treatment of 215 patients undergoing surgery for presumed intermittent exotropia. He concludes that the data suggest that the occurrence of monofixation syndrome after surgery for presumed intermittent exotropia in most cases is probably due to its presence before surgery. Since motor and sensory findings and prognosis with monofixational exotropia differ from intermittent exotropia, he believes that monofixational exotropia should be considered a separate diagnostic entity.

Dr. Kushner found that of the 194 patients included in the two prior studies - all of whom were at least age three at the time of surgery, had bifoveal fusion and did not have manifest microtropia preoperatively - none developed monofixation syndrome postoperatively. Fourteen patients excluded from the previous studies because they were too young for sensory testing were included in the current study, and half of them had monofixation syndrome after surgery. Another seven patients excluded from the previous studies due to the presence of constant microtropia before surgery were included in the current study, and all of them had monofixation syndrome after surgery.