Clinical features and the risk factors of infantile exotropia recurrence

Purpose: To evaluate the clinical features and the risk factors of recurrence in infantile exotropia. Design: Retrospective, observational case series. Methods: The clinical records of 20 infantile exotropia patients who underwent exotropia surgery were reviewed retrospectively. Patients were divided into 2 groups according to the amount of exodeviation present at 1 year after surgery. Preoperative patient characteristics and postoperative alignments were evaluated at 1 day and 1, 3, 6, and 12 months after surgery. Results: The successful group was composed of 12 patients with an alignment of less than 10 prism diopters (PD) of exodeviation, and the recurrent group was composed of 8 patients with an alignment of 10 PD or more of exodeviation (range, 10 to 18 PD) at 1 year after surgery. The incidences of dissociated vertical deviation, inferior oblique overaction, and rates of constancy before operation were not significantly different in the 2 groups (P = .603, P = .158, and P = .347, respectively), and postoperative deviations were not significantly different at 1 day after surgery. However, postoperative deviations were significantly different in the 2 groups at 1 month (P = .069) and 3 months (P < .001) after surgery, and this difference was maintained at 12 months after surgery. Furthermore, correlation between initial alignments at 1 month after surgery and final alignments was significant in successful group (P = .012). Conclusions: No single factor affecting the surgical outcome was identified in infantile exotropia, but the recurrence of infantile exotropia was apparent from the first postoperative month.