Nomogram for predicting secondary surgery in patients with concomitant exotropia
Abstract Concomitant exotropia (CX), a common form of strabismus, often requires surgical correction, yet up to 60% of patients undergo secondary surgery (SS) due to recurrence or residual deviation. Current risk prediction tools remain limited by inconsistent variables and short-term follow-up. Thi...
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Nature Portfolio
2025-05-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-01463-8 |
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| author | Haihua Liu Rongjun Liu Ruiying Li Kaixiu Li |
| author_facet | Haihua Liu Rongjun Liu Ruiying Li Kaixiu Li |
| author_sort | Haihua Liu |
| collection | DOAJ |
| description | Abstract Concomitant exotropia (CX), a common form of strabismus, often requires surgical correction, yet up to 60% of patients undergo secondary surgery (SS) due to recurrence or residual deviation. Current risk prediction tools remain limited by inconsistent variables and short-term follow-up. This study aimed to develop and validate a nomogram integrating long-term follow-up data to predict individualized SS risk in CX patients. This is a retrospective cohort study of patients with CX who underwent surgery at the Peking University First Hospital between January 1, 2008, and December 31, 2010. Of the 355 CX cases included, 70% were randomly assigned to the training set (n = 248) and 30% to the validation set (n = 107). Demographic and clinical variables were ascertained at hospital admission and discharge and screened using multivariate Cox proportional hazards regression analysis to construct predictive models and generate a one-, three-, and six-year alignment rate nomogram. This nomogram provided an estimate of the risk of SS in patients with surgically treated CX. Internal validation was conducted using the concordance index (C-index) and calibration curve for the training and validation sets, respectively. Four independent prognostic factors were identified: age of onset, refraction, types, and deviation angles one week after surgery entered into the nomogram. The proposed nomogram showed favorable discrimination and accuracy in the training and validation sets. The C-indexes of the training and validation sets were 0.83(95%CI:0.71 ~ 0.95) and 0.80(95%CI: 0.70 ~ 0.89), respectively. The proposed nomogram may serve as a predictive tool for prognostic evaluation of CX surgery. |
| format | Article |
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| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-7ef17d8e75c14ddca2bd652d6ff641ec2025-08-20T02:03:30ZengNature PortfolioScientific Reports2045-23222025-05-0115111110.1038/s41598-025-01463-8Nomogram for predicting secondary surgery in patients with concomitant exotropiaHaihua Liu0Rongjun Liu1Ruiying Li2Kaixiu Li3Department of Ophthalmology Center, Peking University First HospitalDepartment of Ophthalmology Center, Peking University First HospitalDepartment of Ophthalmology Center, Peking University First HospitalDepartment of Ophthalmology Center, Peking University First HospitalAbstract Concomitant exotropia (CX), a common form of strabismus, often requires surgical correction, yet up to 60% of patients undergo secondary surgery (SS) due to recurrence or residual deviation. Current risk prediction tools remain limited by inconsistent variables and short-term follow-up. This study aimed to develop and validate a nomogram integrating long-term follow-up data to predict individualized SS risk in CX patients. This is a retrospective cohort study of patients with CX who underwent surgery at the Peking University First Hospital between January 1, 2008, and December 31, 2010. Of the 355 CX cases included, 70% were randomly assigned to the training set (n = 248) and 30% to the validation set (n = 107). Demographic and clinical variables were ascertained at hospital admission and discharge and screened using multivariate Cox proportional hazards regression analysis to construct predictive models and generate a one-, three-, and six-year alignment rate nomogram. This nomogram provided an estimate of the risk of SS in patients with surgically treated CX. Internal validation was conducted using the concordance index (C-index) and calibration curve for the training and validation sets, respectively. Four independent prognostic factors were identified: age of onset, refraction, types, and deviation angles one week after surgery entered into the nomogram. The proposed nomogram showed favorable discrimination and accuracy in the training and validation sets. The C-indexes of the training and validation sets were 0.83(95%CI:0.71 ~ 0.95) and 0.80(95%CI: 0.70 ~ 0.89), respectively. The proposed nomogram may serve as a predictive tool for prognostic evaluation of CX surgery.https://doi.org/10.1038/s41598-025-01463-8ExotropiaSurgeryRiskPrediction |
| spellingShingle | Haihua Liu Rongjun Liu Ruiying Li Kaixiu Li Nomogram for predicting secondary surgery in patients with concomitant exotropia Scientific Reports Exotropia Surgery Risk Prediction |
| title | Nomogram for predicting secondary surgery in patients with concomitant exotropia |
| title_full | Nomogram for predicting secondary surgery in patients with concomitant exotropia |
| title_fullStr | Nomogram for predicting secondary surgery in patients with concomitant exotropia |
| title_full_unstemmed | Nomogram for predicting secondary surgery in patients with concomitant exotropia |
| title_short | Nomogram for predicting secondary surgery in patients with concomitant exotropia |
| title_sort | nomogram for predicting secondary surgery in patients with concomitant exotropia |
| topic | Exotropia Surgery Risk Prediction |
| url | https://doi.org/10.1038/s41598-025-01463-8 |
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