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Immediate sequential bilateral cataract surgery and monovision in patients suffering of primary infantile exotropia

Poster Details

First Author: S. Giugno ITALY

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Abstract Details


Primary infantile exotropia is a rare strabismus disorder in which outward deviation of one or both eyes is present: Onset is before age 6 months and is very rare (0.00006%). The goal consists in treating associated amblyopia and squint surgery within the first 6 months of life to maximize potential for attaining single binocular vision with stereopsis: nevertheless it is achieved in only 29% of patients . The purpose of my work was to obtain spectacles independence in 6 adult patients suffering of primary infantile exotropia, absence of binocular vision, alternate fixation of gaze.


Studio Oculistico Dr. Salvatore Giugno Viale Mario Gori 63, Niscemi (CL) Italia


A total of 6 patients aged from 55 to 65 yo were enrolled. The subjects suffered of primary infantile exotropia, alternate fixation gaze and absence of stereopsis and cataract: they required spectacles independence by far and near. Considering the absence of binocular vision in every patient we planned to perform phacoemulsification and IOL implantation: refractive target was emmetropia in the dominant eye by far and a moderate myopia (-2 diopters) in the non-dominant one.


Immediate sequential bilateral cataract surgery was performed using a standard technique. After surgery mean best uncorrected visual acuity was -0.1 +/- 0,1log MAR by far in the dominant eye, mean BCVA was -0,10 +/- 0,1 Log MAR with -2 Sphere in the non dominant eye, by near, in the dominant eye mean best corrected visual acuity was Jaeger 1 +/- 1 with + 2 sphere in the dominant eye and mean best uncorrected visual acuity was Jaeger 1 +/- 1 without correction in the other one


Nevertheless nowadays Extended depth of focus IOL and trifocal IOL can offer excellent results in terms of spectacles independence, in selected patients with alternate fixation gaze, no stereopsis and no diplopia, immediate sequential bilateral cataract surgery with monofocal IOL correcting one eye by far and the other eye by near is a really effective technique to achieve spectacles independence without glares, halos and any reduction of contrast sensitivity

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