Cochrane · systematic review · CD003737
Interventions for intermittent exotropia
Pang, Y, Gnanaraj, L, Gayleard, J, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Eyes and VisionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
10
No studies
18
Included studies
NR
No studies 18 · 64.3%Ungraded 0 · 0%Very low 1 · 3.6%Low 5 · 17.9%Moderate 2 · 7.1%High 2 · 7.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Bilateral lateral rectus recession compared with unilateral lateral rectus recession with medial rectus resection for intermittent exotropia
Population: people with intermittent exotropia, aged 3 to < 11 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Motor alignment at near Change in exotropia control at near fixation, measured from baseline to 3 years using the prism and alternate cover test Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | MD 1 | 1 study · 163 participants | Moderate Downgraded: imprecision |
Stereoacuity at near Loss of ≥ 2 octaves near stereoacuity, measured using the Preschool Randot test 3 years after surgery Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | RR 0.77 [0.35, 1.71] | 1 study · 163 participants | Low Downgraded: risk of bias, imprecision |
Stereoacuity at distance Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | no estimate extracted | NR | No studies |
Motor alignment at distance Change in exotropia control at near fixation, measured from baseline to 3 years using the prism and alternate cover test Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | MD 2 | 1 study · 163 participants | Moderate Downgraded: imprecision |
Motor fusion test Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | no estimate extracted | NR | No studies |
Minor adverse events Defined as any adverse event within 8 weeks of surgery that does not require further intervention Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | RR 7.36 [0.39, 140.65] | 1 study · 197 participants | Low Downgraded: risk of bias, imprecision |
Quality of life measures Measured at 3 years using the IXTQ scores for children, parents, or parent proxies (i.e. parents' perception of their children's quality of life). Scores could range from 0 (worst quality of life) to 100 (best quality of l... Bilateral lateral rectus recession vs unilateral lateral rectus recession with medial rectus resection | no estimate extracted | 1 study · 163 participants | Low Downgraded: risk of bias, imprecision |
Patching compared with active observation for intermittent exotropia
Population: people with intermittent exotropia, aged less than 11 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Motor alignment at near fixation Measured using PACT at 6 months Patching vs active observation | no estimate extracted | 2 studies · 511 participants | High |
Stereoacuity at near Measured using the Preschool Randot, Titmus fly, and Titmus circles tests at 40 cm at 6 months Patching vs active observation | MD 0 | 1 study · 324 participants | Low Downgraded: risk of bias, imprecision |
Stereoacuity at distance Loss of ≥ 2 octaves near stereoacuity, measured using the Preschool Randot test 3 years after surgery Patching vs active observation | no estimate extracted | NR | No studies |
Motor alignment at distance fixation Measured using PACT at 6 months Patching vs active observation | no estimate extracted | 2 studies · 511 participants | High |
Motor fusion test Patching vs active observation | no estimate extracted | NR | No studies |
Minor adverse events Defined as any adverse event within 8 weeks of surgery that does not require further intervention Patching vs active observation | no estimate extracted | NR | No studies |
Quality of life measures Measured at 3 years using the IXTQ scores for children, parents, or parent proxies (i.e. parents' perception of their children's quality of life). Scores could range from 0 (worst quality of life) to 100 (best quality of l... Patching vs active observation | no estimate extracted | NR | No studies |
Prism adaptation test with eye muscle surgery compared with eye muscle surgery alone for intermittent exotropia
Population: people with intermittent exotropia, aged 5 to 49 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Motor alignment at near fixation Measured using PACT at 6 months Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Stereoacuity at near Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Stereoacuity at distance Measured using the Preschool Randot test 3 years after surgery Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Motor alignment at distance fixation Measured using PACT at 6 months Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Motor fusion test Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Minor adverse events Defined as any adverse event within 8 weeks of surgery that does not require further intervention Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Quality of life measures Measured at 3 years using the IXTQ scores for children, parents, or parent proxies (i.e. parents' perception of their children's quality of life). Scores could range from 0 (worst quality of life) to 100 (best quality of l... Prism adaptation test with eye muscle surgery vs eye muscle surgery alone | no estimate extracted | NR | No studies |
Lateral rectus recession and medial rectus plication compared with lateral rectus recession and medial rectus resection for intermittent exotropia
Population: people with intermittent exotropia, aged over 6 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Motor alignment at near fixation Measured using the PACT at 6 months Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | no estimate extracted | NR | No studies |
Stereoacuity at near Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | no estimate extracted | NR | No studies |
Stereoacuity at distance Loss of ≥ 2 octaves near stereoacuity Measured using the Preschool Randot test 3 years after surgery Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | no estimate extracted | NR | No studies |
Motor alignment at distance fixation Measured using the PACT at 1 year Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | MD 0.66 | 1 study · 60 participants | Low Downgraded: imprecision |
Motor fusion test Measured using the synoptophore and Titmus fly test at 1 year Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | RR 0.92 [0.48, 1.74] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Minor adverse events Defined as any adverse event within 8 weeks of surgery that does not require further intervention Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | no estimate extracted | NR | No studies |
Quality of life measures Measured at 3 years using the IXTQ scores for children, parents, or parent proxies (i.e. parents' perception of their children's quality of life). Scores could range from 0 (worst quality of life) to 100 (best quality of l... Lateral rectus recession and medial rectus plication vs lateral rectus recession and medial rectus resection | no estimate extracted | NR | No studies |