[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-447108-105":59,"doc-detail-447108-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","preoperative-factors-associated-with-multiple-strabismus-surgeries-in-basic-exotropia-research-findings","Preoperative factors associated with multiple strabismus surgeries in basic exotropia - research findings","","Compares preoperative clinical features in patients with basic unilateral exotropia who underwent one surgery versus two or three-plus strabismus surgeries. A retrospective cohort of 2,457 patients over 10 years collected best corrected distance visual acuity, refractive error, exotropia magnitude, and amblyopia type and severity. Three-plus surgery cases showed worse BCVA, greater hyperopic shift, and stronger deviation-angle risk, while two surgeries were independently linked to larger horizontal deviation. Concludes that refractive and amblyopia optimization and counseling are crucial for high-risk patients.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/preoperative-factors-associated-with-multiple-strabismus-surgeries-in-basic-exotropia-research-findings/447108/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/preoperative-factors-associated-with-multiple-strabismus-surgeries-in-basic-exotropia-research-findings/447108.png","ImageObject",300,407,{"name":92,"@type":93},"Indoniesian Boy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-04","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the primary purpose of the study?","Question",{"text":112,"@type":113},"To compare preoperative clinical features between patients needing one versus two or three-plus strabismus surgeries for basic unilateral exotropia.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which preoperative measurements were analyzed?",{"text":117,"@type":113},"Best corrected distance visual acuity (BCVA), refractive error, magnitude of exotropia, and amblyopia type and severity.",{"name":119,"@type":110,"acceptedAnswer":120},"What preoperative factors increased the likelihood of requiring more than one surgery?",{"text":121,"@type":113},"Worse preoperative BCVA, greater hyperopia, and a greater angle of deviation were associated with a higher likelihood of multiple surgeries.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},447108,1790949959,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090760608,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Preoperative factors associated with multiple strabismus surgeries in basic exotropia  \nMohammad Reza Akbari, Babak Masoomian, Arash Mirmohammadsadeghi, Elham Azizi, Hayder Resen Hussain and Masoud Khorrami-Nejad  \nAbstract  \nPurpose: To compare the preoperative clinical features in patients with basic unilateral exotropia who underwent single versus two and three or more strabismus surgeries. Design: retrospective  \nMethod: Two thousand four hundred fifty-seven patients with unilateral basic exotropia were recruited over 10 years. Of these, 1886 (76 .8%) had one surgery, 411 (16 . 7%) had two, and 160 (6 . 5%) had three or more surgical interventions. Preoperative data included the best corrected distance visual acuity (BCVA), refractive error, magnitude of exotropia, and amblyopia type and severity.  \nResults: The mean age at first surgery was 26.3 ± 13.35 years (age range: 2–77) with no significant difference between groups with one, two, and three or more surgeries (p = 0 . 770) . Mean BCVA in the strabismic eye was significantly worse in patients who underwent three or more surgeries (0 .82 ± 0.076 logMAR) than those who had one (0 .55 ± 0.018 logMAR; p \u003C 0. 001) or two surgeries (0 .52 ± 0.038 logMAR; p \u003C 0. 001) . Spherical equivalent refraction in the strabismic eye was significantly more hyperopic in patients who underwent three or more surgeries (0 .79 ± 0.37 D), compared with those with one (−0 .95 ± 0.094 D; p \u003C 0. 001) or two surgeries (−0 .36 ± 0.16 D; p \u003C 0. 001) . Relative to one surgery, undergoing two surgeries was independently associated with larger distance horizontal deviation (adjusted odds ratio (aOR) per prism diopter = 1 . 012; 95% CI, 1.003–1. 022; p = 0 . 009) . Undergoing three or more surgeries was independently associated with amblyopia severity (aOR = 2 .368; 95% CI, 1.279–4.384; p = 0 . 006); in the strabismic eye, and higher spherical power markedly increased the odds (aOR = 13 . 553; 95% CI, 12.801–14.348; p \u003C . 001) .  \nConclusion: Worse preoperative BCVA, greater hyperopia, and higher angle of deviation were associated with a greater likelihood of requiring more than one surgery. Surgeons should optimize preoperative refractive and amblyopia management and counsel high-risk patients about the increased likelihood of additional procedures.  \nKeywords: amblyopia, exodeviation, exotropia, reoperation, strabismus surgery  \nReceived: 5 July 2025; revised manuscript accepted: 26 November 2025.  \nIntroduction  \nChildhood unilateral exotropia might be constant when it manifests in one eye all the time or intermittent when it manifests when the child is tired, ill, not focusing, or at the end of the day.1 Intermittent exotropia (IXT) has been recognized as the most common form of childhood-onset  \nexotropia, and it affects approximately 1% of the population.2–4 Burian classified IXT into four forms based on the difference in magnitude between the distance and the near: basic, convergence insufficiency, true divergence excess, and pseudo divergence excess.5 Previous studies have reported varying results regarding the natural  \nTherAdv Ophthalmol 2026, Vol. 18: 1–11  \nDOI: 10. 1177/ 25158414251407867 © The Author(s), 2026.  \nArticle reuse guidelines: [sagepub.com/journals](sagepub.com/journals)permissions  \nCorrespondence to:  \nMasoud Khorrami-Nejad  \nSchool of Rehabilitation, Tehran University of Medical Sciences, Enghelab St, Tehran 1148965111, Iran  \nTranslational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran  \ndr.khorraminejad@gmail. com  \nMohammad Reza Akbari Babak Masoomian Arash Mirmohammadsadeghi  \nTranslational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran  \nElham Azizi  \nDepartment of Optometry and Vision Sciences, University of Melbourne, Melbourne, VIC, Australia  \nHayder Resen Hussain  \nSchool of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran  \n[journals","cbCaiprtTS7qjPP8","https://ap.wps.com/l/cbCaiprtTS7qjPP8","pdf",814713,11,"English","# Abstract\n## Purpose\n## Method\n## Results\n## Conclusion\n# Keywords\n# Introduction","[{\"question\":\"What was the primary purpose of the study?\",\"answer\":\"To compare preoperative clinical features between patients needing one versus two or three-plus strabismus surgeries for basic unilateral exotropia.\"},{\"question\":\"Which preoperative measurements were analyzed?\",\"answer\":\"Best corrected distance visual acuity (BCVA), refractive error, magnitude of exotropia, and amblyopia type and severity.\"},{\"question\":\"What preoperative factors increased the likelihood of requiring more than one surgery?\",\"answer\":\"Worse preoperative BCVA, greater hyperopia, and a greater angle of deviation were associated with a higher likelihood of multiple surgeries.\"}]","Preoperative factors associated with multiple strabismus surgeries in basic exotropia - research findings | PDF",1790718818,28]