Preoperative factors associated with multiple strabismus surgeries in basic exotropia.

Purpose: To compare the preoperative clinical features in patients with basic unilateral exotropia who underwent single versus two and three or more strabismus surgeries. Design: retrospective Method: Two thousand four hundred fifty-seven patients with unilateral basic exotropia were recruited over...

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Publicado en:Therapeutic Advances in Ophthalmology Vol. 18; pp. 1 - 12
Autores principales: Akbari, Mohammad Reza, Masoomian, Babak, Mirmohammadsadeghi, Arash, Azizi, Elham, Hussain, Hayder Resen, Khorrami-Nejad, Masoud
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 1/4/2026
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Preoperative factors associated with multiple strabismus surgeries in basic exotropia.
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        au:
          Akbari, Mohammad Reza
          Masoomian, Babak
          Mirmohammadsadeghi, Arash
          Azizi, Elham
          Hussain, Hayder Resen
          Khorrami-Nejad, Masoud
        affil: Conceptualization, Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
      sug:
        subj:
          Strabismus Surgery
          Reoperation Methods
          Preoperative Care
          Postoperative Complications Risk Factors
          Risk Assessment
          Human
          Male
          Female
          Adolescence
          Adult
          Iran
          Retrospective Design
          Record Review
          Cross Sectional Studies
          Comparative Studies
          Visual Acuity
          Refractive Errors
          Amblyopia
          Oculomotor Muscles
          Postoperative Period
          One-Way Analysis of Variance
          Post Hoc Analysis
          Chi Square Test
          Multivariate Analysis
          Multiple Logistic Regression
          Odds Ratio
          Confidence Intervals
          Statistical Significance
          Data Analysis Software
          Descriptive Statistics
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: To compare the preoperative clinical features in patients with basic unilateral exotropia who underwent single versus two and three or more strabismus surgeries. Design: retrospective Method: Two thousand four hundred fifty-seven patients with unilateral basic exotropia were recruited over 10 years. Of these, 1886 (76.8%) had one surgery, 411 (16.7%) had two, and 160 (6.5%) had three or more surgical interventions. Preoperative data included the best corrected distance visual acuity (BCVA), refractive error, magnitude of exotropia, and amblyopia type and severity. Results: The mean age at first surgery was 26.3 ± 13.35 years (age range: 2–77) with no significant difference between groups with one, two, and three or more surgeries (p = 0.770). Mean BCVA in the strabismic eye was significantly worse in patients who underwent three or more surgeries (0.82 ± 0.076 logMAR) than those who had one (0.55 ± 0.018 logMAR; p < 0.001) or two surgeries (0.52 ± 0.038 logMAR; p < 0.001). Spherical equivalent refraction in the strabismic eye was significantly more hyperopic in patients who underwent three or more surgeries (0.79 ± 0.37 D), compared with those with one (−0.95 ± 0.094 D; p < 0.001) or two surgeries (−0.36 ± 0.16 D; p < 0.001). Relative to one surgery, undergoing two surgeries was independently associated with larger distance horizontal deviation (adjusted odds ratio (aOR) per prism diopter = 1.012; 95% CI, 1.003–1.022; p = 0.009). Undergoing three or more surgeries was independently associated with amblyopia severity (aOR = 2.368; 95% CI, 1.279–4.384; p = 0.006); in the strabismic eye, and higher spherical power markedly increased the odds (aOR = 13.553; 95% CI, 12.801–14.348; p <.001). Conclusion: Worse preoperative BCVA, greater hyperopia, and higher angle of deviation were associated with a greater likelihood of requiring more than one surgery. Surgeons should optimize preoperative refractive and amblyopia management and counsel high-risk patients about the increased likelihood of additional procedures.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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