Binocular photophobia after surgical treatment in intermittent exotropia.

Purpose: This study examined the rate of binocular photophobia in intermittent exotropia patients before surgical correction, and the factors affecting this rate. The study also investigated the factors affecting postsurgical disappearance of binocular photophobia.

Methods: The study involved 162 basic type intermittent exotropia patients who underwent surgical correction between March 2001 and January 2006. The study did not include patients with entropion, congenital cataract, or retinal abnormalities. Parents of the patients were questioned to determine which patients had monocular eye closure in bright light and which had disappeared after bilateral lateral rectus recession. Data was analyzed to determine the factors affecting monocular eye closure before surgery and disappearance after surgery.

Results: Of 162 patients, 96 patients had binocular photophobia (60.2%). Photophobia was found to be associated with an angle of exodeviation at distance >25 Prism Diopter (Delta) (p = 0.02), and stereoacuity worse than 60 s (p = 0.02). We defined satisfactory surgical outcome as a deviation of <10 Delta. Of the 81 patients with satisfactory outcomes, 46 showed disappearance of binocular photophobia (53.5%). No factor was found to be associated with loss of binocular photophobia.

Conclusion: The angle of strabismus and stereoacuity were found to affect the occurrence of binocular photophobia. Successful surgery treated binocular photophobia in 53.5% of patients. Regardless of the surgical result, clinicians should educate patients in terms of the possibility of persistence of postsurgical photophobia.