@article {503916, title = {Goal-determined metrics to assess outcomes ofexotropia surgery.}, journal = {J AAPOS}, year = {2015}, month = {2015 Jul 30}, abstract = {PURPOSE: To present a goal-determined methodology for monitoring outcomes after surgery for exotropia. METHODS: The goal-determined metric required surgeons to rank four possible goals preoperatively: (1) binocular potential, (2) restoration of eye contact, (3) diplopia control; and (4) torticollis management. Potential preoperative risk factors were noted. Goal-specific outcomes criteria were applied to the latest sensory-motor examination, 2-6 months after surgery. The medical records of patients who underwent surgery from 2007 to 2012 were retrospectively reviewed with respect to the goal-directed metric. RESULTS: A total of 852 patients were evaluated in the study period: 411 for restoration of eye contact; 347 for binocular potential; 78 for diplopia resolution; and16 for torticollis management. Excellent (62\%) or good (16\%) outcomes were achieved in 78\%. Procedures to resolve diplopia (OR, 6.56; 95\% CI, 3.39-12.68) and to restore eye contact (OR, 3.74; 95\% CI, 2.65-5.29) were more likely to result in excellent outcomes than procedures to improve binocular potential. Simultaneous surgery for dissociated vertical deviation (OR, 0.38; 95\% CI, 0.16-0.92) and preoperative near deviation >=50(Δ) (OR, 0.27; 95\% CI, 0.17-0.42) limited likelihood of an excellent outcome. Outcomes monitored by simultaneous rather than alternate prism and cover test were more likely graded excellent (OR, 5.16; 95\% CI, 3.50-7.62). Applying motor criteria from the binocular potential goal to the entire cohort diminished putative outcomes (P \< 0.001). CONCLUSIONS: Goal-determined metric monitoring outcomes of exotropia surgery provides outcomes germane to the reason for intervention, enables analysis of risk factors affecting outcomes, and facilitates reporting on heterogeneous populations.}, issn = {1528-3933}, doi = {10.1016/j.jaapos.2015.04.009}, author = {Chang, Yoon-Hee and Melvin, Patrice and Dagi, Linda R} }