Skip to main content

Advertisement

SpringerLink
Log in

Strong fixation preference in patients with manifest exotropia: Does it matter or not?

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the influence of strong fixation preference on clinical and surgical outcomes, in non-amblyopic patients with basic-type intermittent exotropia (IXT).

Materials and methods

The records of patients were retrospectively investigated. Non-amblyopic patients with the diagnosis of basic-type IXT were enrolled and divided into two groups according to the presence of strong fixation preference (SFP). Best-corrected visual acuity, refractive errors, deviations in near and distance, convergence patterns, motor fusion, stereopsis were evaluated and compared. Patients who underwent surgery in each group composed subgroups and postoperative deviations, convergence patterns, motor fusion, and stereopsis were compared.

Results

Seventy-seven patients were enrolled and divided into two groups according to the presence of SFP: patients with SFP composed Group 1 and patients with alternating fixation composed Group 2. Statistically significant difference was seen between groups in terms of motor fusion (p: 0.02). Other parameters did not differ between groups. Data obtained from patients in subgroups of each group were not statistically different.

Conclusion

The evaluation of basic-type exotropic patients according to their fixation preference revealed us that motor fusion might be affected by strong fixation preference. We also observed that SFP did not affect surgical success rates, convergence patterns, and stereopsis of exotropic patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Burian HM, Spivey BE (1965) The surgical management of exodeviations. Am J Ophthalmol 59:603–620

    Article  CAS  Google Scholar 

  2. Joyce KE, Beyer F, Thomson RG, Clarke MP (2015) A systematic review of the effectiveness of treatments in altering the natural history of intermittent exotropia. Br J Ophthalmol 99(4):440–450

    Article  Google Scholar 

  3. Benish R, Flanders M (1994) The role of stereopsis and early postoperative alignment in long-term surgical results of intermittent exotropia. Can J Ophthal 29:119–124

    Google Scholar 

  4. Olitsky SE (1998) Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia. J Pediatr Ophthalmol Strabismus 35:146–148

    CAS  PubMed  Google Scholar 

  5. Yoo G, Ha SG, Kim SH (2019) Distance suppression as a predictive factor in progression of intermittent exotropia. Korean J Ophthalmol 33(5):446–450. https://doi.org/10.3341/kjo.2019.0054

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jung EH, Kim SJ, Yu YS (2016) Factors associated with surgical success in adult patients with exotropia. JAAPOS 20(6):511–514

    Google Scholar 

  7. Repka MX, Chandler DL, Holmes JM, Donahue SP, Hoover DL, Mohney BG et al (2020) The relationship of age and other baseline factors to outcome of initial surgery for intermittent exotropia. Am J Ophthalmol 212:153–161

    Article  Google Scholar 

  8. Somer D, Demirci S, Cinar FG, Duman S (2007) Accommodative ability in exotropia: predictive value of surgical success. JAAPOS 11(5):460–464

    Google Scholar 

  9. Trakanwitthayarak S, Patikulsila P (2017) Prognostic factors predicting the surgical outcomes of bilateral lateral rectus recession for patients with concomitant exotropia in Chiang Mai University Hospital. J Med Assoc Thai 100(1):64–69

    PubMed  Google Scholar 

  10. Procianoy L, Procianoy E (2010) The accuracy of binocular fixation preference for the diagnosis of strabismic amblyopia. JAAPOS 14(3):205–210

    Google Scholar 

  11. Alharkan DH, Khan AO (2014) False amblyopia prediction in strabismic patients by fixation preference testing correlates with contralateral ocular dominance. JAAPOS 18(5):453–456

    Google Scholar 

  12. Attarzadeh A, Hoseinirad A, Farvadin M, Talebnejad MR, Alipour A (2009) Reliability of fixation preference for detecting amblyopia in strabismic patients. J Ophthalmic Vis Res 4(3):160–163

    PubMed  PubMed Central  Google Scholar 

  13. Çakır B, Bursalı Ö, Özmen S, Aksoy NÖ, Babashli T, Alagöz G (2019) Factors influencing stereopsis in patients with both refractive accommodative esotropia and amblyopia. Int Ophthalmol 39(6):1263–1267

    Article  Google Scholar 

  14. Levi DM, Knill DC, Bavelier D (2015) Stereopsis and amblyopia: a mini-review. Vis Res 114:17–30. https://doi.org/10.1016/j.visres.2015.01.002

    Article  PubMed  Google Scholar 

  15. Hakim OM (2007) Association between fixation preference testing and strabismic pseudoamblyopia. J Pediatr Ophthalmol Strabismus 44(3):174–177

    Article  Google Scholar 

  16. Pedraza IS, Clarke MP, Read J (2011) Single vision during ocular deviation in intermittent exotropia. Ophthalmic Physiol Opt 31:45–55

    Article  Google Scholar 

  17. Chaumillon R (2017) Asymmetry in visual information processing depends on the strength of eye dominance. Neuropsychologia 96:129–136

    Article  Google Scholar 

  18. Yıldırım C, Mutlu FM, Chen Y, Altınsoy HI (1999) Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery. Am J Ophthalmol 128(2):222–230

    Article  Google Scholar 

  19. Huh J, Ha SG, Kim SH (2000) Recovery from suppression with successful motor alignment after surgery for intermittent exotropia. J Pediatr Ophthalmol Strabismus 57(1):21–26

    Article  Google Scholar 

  20. Yan X, Lin X (2018) Postoperative stereopsis in adult patients with horizontal comitant strabismus with normal vision who are stereoblind. J Pediatr Ophthalmol Strabismus 55(6):407–411

    Article  Google Scholar 

  21. Yao J, Qu X, Lin J, Liu H (2019) Does successful surgical correction of childhood large angle exotropia in adults make any difference to binocularity and quality of life? Strabismus 27(3):149–155

    Article  Google Scholar 

Download references

Funding

This study was not funded by any company.

Author information

Authors and Affiliations

  1. Sakarya University Education and Research Hospital, Sakarya, Turkey

    Burcin Cakir, Nilgün Özkan Aksoy, Özlem Bursalı, Sedat Özmen & Erkan Çelik

Authors
  1. Burcin Cakir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nilgün Özkan Aksoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Özlem Bursalı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sedat Özmen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Erkan Çelik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Burcin Cakir.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethics approval

Prior ethical approval from the Sakarya University Institutional Review Board (IRB: 71522473/050.01.04/170) was taken. The study was performed in adherence to the 1964 Declaration of Helsinki.

Informed consent

Written informed consent was obtained from each subject or from parents of each subject, in the study.

Consent for publication

Patients or parents of patients signed informed consent regarding publishing their data.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cakir, B., Aksoy, N.Ö., Bursalı, Ö. et al. Strong fixation preference in patients with manifest exotropia: Does it matter or not?. Int Ophthalmol 41, 527–532 (2021). https://doi.org/10.1007/s10792-020-01603-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-020-01603-1

Keywords

Search

Navigation