Changes of corneal topographic measurements and higher-order aberrations after surgery for exotropia

Purpose To analyze changes in corneal topographic measurements and higher-order aberrations (HOAs) after horizontal muscle surgery for exotropia. Design Retrospective, observational study. Methods A total of 131 eyes of 121 patients who had undergone surgery for exotropia were included. The eyes with unilateral lateral rectus (ULR) or bilateral lateral rectus (BLR) recession(s) were assigned to group A, and those with unilateral lateral rectus recession & medial rectus resection (R&R) to group B. Corneal topographic measurements and HOAs were compared between the preoperative and postoperative periods using a Placido-dual Scheimpflug analyzer (Galilei 2 (TM), Ziemer, Port., Switzerland) for each group. Results In group A, simulated keratometery (sim K) was significantly changed until 3 months postoperatively relative to the preoperative value (postoperative 1 week, p = 0.017; 1 month, p = 0.037; and 3 months, p = 0.023, respectively). All steep K (steep sim K, steep-Kpost, and TCP-steep K) parameters also were significantly changed at postoperative 1 month (p<0.001, p = 0.015, p<0.001, respectively), but not at 3 months. Among the higher-order aberrations, spherical aberration (Z(4)(0)) and secondary horizontal astigmatism (Z(4)(2)) at postoperative 1 week had significantly changed from the preoperative values, as had horizontal quadrafoil (Z(4)(4)) at 1 month. However, in group B, only vertical quadrafoil (Z(4)(-4)) showed statistically significant changes, at postoperative 1 and 3 months. None of the other postoperative parameters was significantly different from the corresponding preoperative value. Conclusion Lateral rectus recession induced changes in both corneal topographic measurements and HOAs, whereas R&R did so only in HOAs. These changes might explain some patients' complaints about poor quality of vision.