The effect of axial length on the surgical outcomes of intermittent exotropia in children

Abstract

Purpose

This study aimed to evaluate the effect of axial length on the surgical results of bilateral lateral rectus recession (BLR) in patients with basic-type intermittent exotropia (IXT).

Methods

This retrospective study included patients aged 4–10 years with basic-type IXT who underwent standard symmetric BLR and had at least 6 months of follow-up. The magnitude of deviation was assessed at postoperative day 1, week 1, month 1, month 3, and month 6. The amount of correction per millimeter of recession was analyzed. Age-adjusted axial length (AL) percentiles were calculated based on normative data. Multivariate linear regression analysis was performed to evaluate the association between AL and surgical outcomes while adjusting for age, sex, and postoperative deviation at 1 week.

Results

A longer AL was associated with a smaller amount of correction per millimeter of recession at postoperative day 1 and week 1 at both distance and near (p < 0.05). However, this association was not observed after 1 month postoperatively. In multivariable analysis, AL percentile was not independently associated with postoperative deviation at 6 months.

Conclusions

Axial length was associated with the early surgical response after BLR in children with basic-type IXT, but this effect diminished over time. Adjustment of surgical dosage based solely on AL may not be necessary for long-term outcomes.

Keywords

Axial length bilateral lateral rectus recession intermittent exotropia surgical dose

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