Outcomes of surgery in children with early-onset exotropia

Objective To evaluate the clinical characteristics and surgical outcomes of early-onset exotropia and to compare differences between constant and intermittent exotropia at presentation. Methods The medical records of 45 exotropia patients with a reported onset before 1 year of age who were operated on between 2008 and 2011 were reviewed, and the clinical characteristics and surgical outcomes of these patients were analyzed retrospectively. Patients were then divided into two groups according to type of exotropia at presentation: a constant (XT) group and an intermittent (X(T)) group. Clinical features and surgical results of exotropia were then compared between these two groups. Results The mean age of onset of exodeviation in 45 patients was 9.3 +/- 3.8 months. Mean age at surgery was 4.5 +/- 2.4 years, and the mean postoperative follow-up period was 17.3 months (range, 6-37 months). Of the 45 patients, 67% showed alignment of less than +/- 10 prism diopters (PD) at final visit. Gross stereopsis was achieved in all 34 testable patients, and bifixation developed in 10 patients (29%). Eleven patients were included in XT group and 34 patients in X(T) group. No significant intergroup difference was found between surgical success rates and binocularities. Conclusion Surgical outcomes, both motor and sensory, were not poor in early-onset exotropia patients, even in patients with constant deviation. Good binocular results following surgery can be achieved in children presenting with apparently constant early-onset exotropia.