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  • Age at Time of Surgery for Intermittent Exotropia

    By Jean Shaw
    Selected By: Richard K. Parrish II, MD

    Journal Highlights

    American Journal of Ophthalmology, April 2020

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    Repka et al. set out to determine the link between a child’s age and the outcome of surgery for intermittent exo­tropia (IXT). They found that younger age at time of surgery is associated with better surgical outcomes.

    For this secondary analysis of pooled data from a prospective randomized trial, the researchers evaluated 197 children between the ages of 3 and 11 (mean age, 6.2 years). All had basic-type IXT of 15 to 40 PD and at least 400 arcsec near stereoacuity. The children were randomly assigned to either 1) bilateral lateral rectus muscle recessions or 2) unilateral lateral rectus recession with medial rectus resection.

    The results of this analysis revealed that the cumulative probability of having a suboptimal surgical outcome at the three-year post-op mark was 28% in children who were at least 3 but younger than 5 years old and approx­imately 50% for those who were age 5 or older. No other significant associ­ations were found for other baseline factors, including magnitude of angle, control score, fixation preference, or near stereoacuity.

    The authors caution that this anal­ysis needs further confirmation from other studies. In particular, they said, the clinical question of whether early or delayed IXT surgery is associated with a better outcome needs to be addressed.

    The original article can be found here.