Asymmetric accommodative response may be linked to recession-resection success in exotropic eyes

Exotropic patients with an asymmetric accommodative response may benefit more from recession-resection procedures than those with no interocular difference in accommodative response, according to a study.

"A decrease in accommodative response of the nondominant eye could be a predicting factor on the outcome of exotropia surgery," the study authors said.

Deniz Somer, MD, and colleagues in Turkey evaluated the state and symmetry of accommodative response in 47 patients with basic intermittent exotropia. The researchers performed dynamic retinoscopy before patients underwent their first operation for exotropia and used the monocular estimate method to obtain a clinical measurement of the degree of binocular accommodative response, according to the study.

Of the 47 patients, 32 (68%) showed a persistent interocular difference in accommodative amplitude of at least 0.75 D. Among these patients, five of 14 patients (35.7%) who underwent lateral rectus recession and 13 of 18 patients (72%) who underwent recession-resection procedures had satisfactory outcomes (P = .039), the authors reported.

Of 15 patients with no interocular difference in accommodation, five of seven patients (71%) who underwent lateral rectus recession and seven of eight patients (87%) who underwent recession-resection procedures had satisfactory outcomes (P = .57), according to the study, published in the October issue of Journal of American Association for Pediatric Ophthalmology and Strabismus.