Analysis Of The Causes And Operation Curative Effect About Secondary Exotropia After Esotropia Surgery

Objective：This study is aimed at analyzing the cause of postoperativesecondary exotropia after esotropia and operation curative effect.Methods：The clinical data of40patients with secondary exotropia afteresotropia surgery in our department of pediatric ophthalmology betweenJanuary2007and December2011were summarized retrospectively, in order toanalysis the surgical tretment and the causes of secondary exotropia afteresotropia surgery.Results：This group of40patients,esotropia of aged between0~4,esotropia surgery age be applied between3~26years old, the average age is12.8years, including10patients with surgery between3~6years old (25%),18cases (45%) between6~12years old,12cases (30%) over12years of age;Postoperative secondary exotropia happens from6months later or more than10years later after the esotropia surgical tretment, and the incidence rate is62.5%within five years.15cases of secondary exotropia patients have a+1.00D~+5.00D hyperopia,19cases have monocular amblyopia, all40patientswithout stereopsis.13case(32.5%) of Secondary exotropia patients beforesurgery with D.V.D (2cases), external oblique a sign (5cases), nystagmus (3cases), the inferior oblique muscle hyperfunction (3cases), and other types ofstrabismus. Cause secondary concomitant esotropia by different surgicalprocedures for: exotropia eyes internal rectus recession18cases (45%),binocular medial rectus muscle back recession surgery joint one side ofexternal rectus shortening surgery9cases (22.5%), monocular medial rectusmuscle back recession surgery7cases (17.5%), monocular medial rectusmuscle recession combined with homonymy musculi rectus lateralis shortening operation6cases (15%). Secondary exotropia surgery with a rectification rateof70%, among them,20cases monocular medial rectus muscle surgery with arectification rate of60%; Monocular medial rectus muscle rectification jointwith shortening surgery4cases, with a rectification rate of75%; Monocularmedial rectus muscle reduction and combined with lateral rectus back recession7cases, with a rate of71.43%; Reduction of binocular medial rectus muscle9cases, with a rate of88.89%.Conclusions: The main influence factors cause secondary exotropia canbe: onset age of Esotropia and Surgery age prematurely，monocular amblyopia,stereoscopic, combind with other type of strabismus. The binocular medialrectus muscle back reduction technique is the key to this change.Secondaryexotropia happens at short time after the surgery, or happens in a longer periodtime. So be sure to follow-up on a regular basis. Binocular medial rectusmuscle restoration repair of monocular medial rectus muscle restoration joint ofexternal rectus back recession is preferred for the treatment of secondaryexotropia.