Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia
Background: Previous research on the factors associated with surgical dose-response in strabismus surgery for exotropia has yielded inconsistent results. This study determined the factors influencing surgical dose-response in exotropia patients who underwent recession and resection (R&R). Method...
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Elsevier
2025-02-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664624001840 |
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| author | I-Wen Lai Li-Li Wu Yao-Lin Liu Tzu-Hsun Tsai |
| author_facet | I-Wen Lai Li-Li Wu Yao-Lin Liu Tzu-Hsun Tsai |
| author_sort | I-Wen Lai |
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| description | Background: Previous research on the factors associated with surgical dose-response in strabismus surgery for exotropia has yielded inconsistent results. This study determined the factors influencing surgical dose-response in exotropia patients who underwent recession and resection (R&R). Methods: Exotropia patients who underwent unilateral R&R at the National Taiwan University Hospital between 2006 and 2021 were evaluated. Deviation-angle differences in prism diopters (PD) were measured preoperatively and at 1 month postoperatively. Surgical dose-response (PD/mm) was defined as the difference in deviation angle (in PD) divided by the surgical dose in millimeters. Linear and non-linear regression models were used to evaluate the influence of variables including age, sex, axial length, and preoperative deviation on surgical dose-response. Results: Overall, 295 patients (162 children; 133 adults) were included. Average surgical dose-response in the pediatric and adult groups was 2.82 ± 0.60 PD/mm and 3.02 ± 0.62 PD/mm, respectively. Male sex was negatively correlated with surgical dose-response in children. The surgical dose-response was larger in adults with longer axial length (>25.64 mm) and patients with larger preoperative deviation (>42.6 PD and >38.7 PD in pediatric and adult groups, respectively). Surgical dose-responses peaked at 35.1 years. Conclusion: Age, axial length, and preoperative deviation have a nonlinear effect on surgical dose-responses in exotropia patients undergoing R&R. Surgical dose-responses were larger in patients in young adulthood, with longer axial length and larger preoperative deviation angle. A table with fitted values for surgical dose-response based on age, axial length, and preoperative deviation was established for clinical reference. |
| format | Article |
| id | doaj-art-53b4c306b13e49ec89a791f9632264ef |
| institution | Kabale University |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-53b4c306b13e49ec89a791f9632264ef2025-02-02T05:26:45ZengElsevierJournal of the Formosan Medical Association0929-66462025-02-011242164170Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropiaI-Wen Lai0Li-Li Wu1Yao-Lin Liu2Tzu-Hsun Tsai3Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, TaiwanDepartment of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Ophthalmology, National Taiwan University Hospital 12F, No 7, Zhongshan S. Rd., Zhongzheng Dist. Taipei City, 10002, Taiwan.Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, College of Medicine, National Taiwan University, Hsinchu County, Taiwan; Corresponding author. Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch No. 2, Sec. 1, Shengyi Rd., Zhubei City, Hsinchu County, 302, Taiwan.Background: Previous research on the factors associated with surgical dose-response in strabismus surgery for exotropia has yielded inconsistent results. This study determined the factors influencing surgical dose-response in exotropia patients who underwent recession and resection (R&R). Methods: Exotropia patients who underwent unilateral R&R at the National Taiwan University Hospital between 2006 and 2021 were evaluated. Deviation-angle differences in prism diopters (PD) were measured preoperatively and at 1 month postoperatively. Surgical dose-response (PD/mm) was defined as the difference in deviation angle (in PD) divided by the surgical dose in millimeters. Linear and non-linear regression models were used to evaluate the influence of variables including age, sex, axial length, and preoperative deviation on surgical dose-response. Results: Overall, 295 patients (162 children; 133 adults) were included. Average surgical dose-response in the pediatric and adult groups was 2.82 ± 0.60 PD/mm and 3.02 ± 0.62 PD/mm, respectively. Male sex was negatively correlated with surgical dose-response in children. The surgical dose-response was larger in adults with longer axial length (>25.64 mm) and patients with larger preoperative deviation (>42.6 PD and >38.7 PD in pediatric and adult groups, respectively). Surgical dose-responses peaked at 35.1 years. Conclusion: Age, axial length, and preoperative deviation have a nonlinear effect on surgical dose-responses in exotropia patients undergoing R&R. Surgical dose-responses were larger in patients in young adulthood, with longer axial length and larger preoperative deviation angle. A table with fitted values for surgical dose-response based on age, axial length, and preoperative deviation was established for clinical reference.http://www.sciencedirect.com/science/article/pii/S0929664624001840ExotropiaRecession and resectionSurgical dose-response |
| spellingShingle | I-Wen Lai Li-Li Wu Yao-Lin Liu Tzu-Hsun Tsai Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia Journal of the Formosan Medical Association Exotropia Recession and resection Surgical dose-response |
| title | Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia |
| title_full | Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia |
| title_fullStr | Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia |
| title_full_unstemmed | Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia |
| title_short | Revisiting the surgical table: An analysis of surgical dose-response in Asian exotropia |
| title_sort | revisiting the surgical table an analysis of surgical dose response in asian exotropia |
| topic | Exotropia Recession and resection Surgical dose-response |
| url | http://www.sciencedirect.com/science/article/pii/S0929664624001840 |
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