No posts with label Surgical Outcomes in Intermittent Exotropia Presentation lecture by: Jeffrey D. Colburn, M.D., PGY-3 Preceptor: David Morrison, M.D. Vanderbilt Eye Institute Intermittent Exotropia * Intermittent exotropia x(t) is a latent tendency (phoria) for the eyes to turn out, which is intermittently controlled by fusional convergence. * Characteristics o Typically good bifoveal fusion and stereoacuity when aligned. o Amblyopia is rare in x(t). o X(t) Tends to remain stable or progress. o Progression might result in dense suppression. Intermittent Exotropia * X(t) Sub-types 1. Basic + Angle is equal at near & distance 2. Pseudo-divergence excess (PDE) + Angle is equal at near & distance but appears larger in distance because of masking 3. True divergence excess (TDE) + Angle is larger in distance 4. Convergence insufficiency (CI) + Angle is larger at near Surgical Treatment * Goals o Improve alignment & control o Improve binocular vision * Basic concepts o Recession (weakening procedure) o Resection (strengthening procedure) * Two primary approaches o Bilateral lateral rectus recession (BLRc) o Unilateral recess & resect (R&R) Predictors of Outcomes age pre-op deviation pre-op control sub-type procedure type asymmetric accommodation pre-op deviation central fusion or stereopsis Observations * Effect of pre-operative angle size on surgical outcomes in x(t) patients. * Disparate opinions on the more successful procedure for x(t). Hypotheses * Larger angle x(t) patients have more successful surgical outcomes than smaller angle x(t) patients. * R&R procedures have more successful surgical outcomes than BLRc in the management of x(t). Methods * Retrospective chart review o Inclusion criteria + X(t) surgical cases + January, 2003 through January, 2008 + Age ≤ 18 years Methods * Exclusion criteria o Developmental delay o Vertical deviation o Pattern deviation o Prior surgery o Partially or untreated amblyopia o Monocular exotropia o Constant exotropia o Secondary exotropia o Nystagmus Data collection * Variables considered o Gender o Age at time of surgery o X(t) sub-type o Pre-op deviation o Stereo-acuity o Presence of fusion o Presence of suppression o Procedure type o Deviation post-op visit. Show all posts
No posts with label Surgical Outcomes in Intermittent Exotropia Presentation lecture by: Jeffrey D. Colburn, M.D., PGY-3 Preceptor: David Morrison, M.D. Vanderbilt Eye Institute Intermittent Exotropia * Intermittent exotropia x(t) is a latent tendency (phoria) for the eyes to turn out, which is intermittently controlled by fusional convergence. * Characteristics o Typically good bifoveal fusion and stereoacuity when aligned. o Amblyopia is rare in x(t). o X(t) Tends to remain stable or progress. o Progression might result in dense suppression. Intermittent Exotropia * X(t) Sub-types 1. Basic + Angle is equal at near & distance 2. Pseudo-divergence excess (PDE) + Angle is equal at near & distance but appears larger in distance because of masking 3. True divergence excess (TDE) + Angle is larger in distance 4. Convergence insufficiency (CI) + Angle is larger at near Surgical Treatment * Goals o Improve alignment & control o Improve binocular vision * Basic concepts o Recession (weakening procedure) o Resection (strengthening procedure) * Two primary approaches o Bilateral lateral rectus recession (BLRc) o Unilateral recess & resect (R&R) Predictors of Outcomes age pre-op deviation pre-op control sub-type procedure type asymmetric accommodation pre-op deviation central fusion or stereopsis Observations * Effect of pre-operative angle size on surgical outcomes in x(t) patients. * Disparate opinions on the more successful procedure for x(t). Hypotheses * Larger angle x(t) patients have more successful surgical outcomes than smaller angle x(t) patients. * R&R procedures have more successful surgical outcomes than BLRc in the management of x(t). Methods * Retrospective chart review o Inclusion criteria + X(t) surgical cases + January, 2003 through January, 2008 + Age ≤ 18 years Methods * Exclusion criteria o Developmental delay o Vertical deviation o Pattern deviation o Prior surgery o Partially or untreated amblyopia o Monocular exotropia o Constant exotropia o Secondary exotropia o Nystagmus Data collection * Variables considered o Gender o Age at time of surgery o X(t) sub-type o Pre-op deviation o Stereo-acuity o Presence of fusion o Presence of suppression o Procedure type o Deviation post-op visit. Show all posts
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