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Factors associated with the recurrence of intermittent exotropia and reoperations in the long term

2026-12Artigo científico Acesso aberto
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datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorLino, Pedro
dc.contributor.authorAguiar, Pedro
dc.contributor.authorCunha, João Paulo
dc.date.accessioned2026-04-14T09:07:17Z
dc.date.available2026-04-14T09:07:17Z
dc.date.issued2026-12
dc.descriptionThis research was funded by Fundação para a Ciência e Tecnologia (FCT, Portugal) through national funds to the Associated Laboratory in Translation and Innovation Towards Global Health REAL (LA/P/0117/2020).
dc.description.abstractPurpose: To evaluate long-term reoperation risk after bilateral lateral rectus (BLR) recession for intermittent exotropia (IXT) in a paediatric cohort, and to identify the perioperative factors associated with recurrence and reoperation. Methods: A retrospective observational cohort of 258 children with basic or divergence-excess IXT who underwent BLR recession at CUF Cascais Hospital between 2010 and 2020 was analysed. Clinical variables included age, age at surgery, pre- and immediate postoperative deviation angles, preoperative occlusion therapy, orthoptic treatment, binocular function, and initial surgical success (residual deviation <10 prism dioptres with fusion). Bivariate analyses were performed using t-tests or χ2 tests, and variables with p < 0.10 were entered into multivariable binary logistic regression to identify the independent predictors of reoperation. Model diagnostics included variance inflation factors (VIF), Hosmer-Lemeshow test, and area under the receiver operating characteristic curve (AUC). Significance was set at p < 0.05. Results: Reoperation was required in 11% of cases. Failed initial surgery (adjusted OR = 34.7; p < 0.001), larger preoperative deviation (adjusted OR per PD = 1.143; 95% CI 1.062-1.231; p < 0.001), larger immediate postoperative deviation (adjusted OR per PD = 0.822; 95% CI 0.766-0.881; p < 0.001), and older patient age (adjusted OR per year = 1.261; 95% CI 1.032-1.542; p = 0.024) were independently associated with reoperation. Orthoptic and occlusion therapies showed non-significant trends. Conclusion: In children undergoing BLR for IXT, initial surgical failure and deviation magnitude (pre- and immediate postoperative) are the strongest predictors of reoperation, with age having a modest additional effect. These findings emphasize precise surgical planning and the need for long-term follow-up.eng
dc.identifier.citationLino P, Aguiar P, Cunha JP. Factors associated with the recurrence of intermittent exotropia and reoperations in the long term. Ann Med. 2026;58(1):2620331.
dc.identifier.doi10.1080/07853890.2026.2620331
dc.identifier.issn0785-3890
dc.identifier.issn1365-2060
dc.identifier.urihttp://hdl.handle.net/10400.21/22781
dc.language.isoeng
dc.peerreviewedyes
dc.publisherInforma UK Limited
dc.relation.hasversionhttps://www.tandfonline.com/doi/10.1080/07853890.2026.2620331
dc.relation.ispartofAnnals of Medicine
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectOphthalmology
dc.subjectIntermittent exotropia
dc.subjectStrabismus
dc.subjectChildren
dc.subjectRecurrence
dc.subjectReoperation
dc.subjectSurgery
dc.titleFactors associated with the recurrence of intermittent exotropia and reoperations in the long termeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1
oaire.citation.startPage2620331
oaire.citation.titleAnnals of Medicine
oaire.citation.volume58
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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