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

2026Artigo científico Acesso aberto
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dc.contributor.authorLino, Pedro
dc.contributor.authorAguiar, Pedro
dc.contributor.authorCunha, João Paulo
dc.contributor.institutionLaboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP)
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblTaylor & Francis
dc.date.accessioned2026-05-25T13:36:01Z
dc.date.available2026-05-25T13:36:01Z
dc.date.issued2026
dc.descriptionPublisher Copyright: © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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 the modest additional effect. These findings emphasize precise surgical planning and the need for long-term follow-up.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1033234
dc.identifier.doi10.1080/07853890.2026.2620331
dc.identifier.issn0785-3890
dc.identifier.otherPURE: 163522253
dc.identifier.otherPURE UUID: 58ee549c-c184-4ce0-a59b-b2357d328f4e
dc.identifier.otherScopus: 105034645628
dc.identifier.otherPubMed: 41918225
dc.identifier.otherPubMedCentral: PMC13045167
dc.identifier.otherWOS: 001732196800001
dc.identifier.urihttp://hdl.handle.net/10362/203382
dc.identifier.urlhttps://www.scopus.com/pages/publications/105034645628
dc.language.isoeng
dc.peerreviewedyes
dc.subjectIntermittent exotropia
dc.subjectpaediatric strabismus
dc.subjectrecurrence
dc.subjectreoperation
dc.subjectsurgical success
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleFactors associated with the recurrence of intermittent exotropia and reoperations in the long termen
dc.typejournal article
degois.publication.issue1
degois.publication.titleAnnals of Medicine
degois.publication.volume58
dspace.entity.typePublication
rcaap.rightsopenAccess

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