DR. SHARIKA GANJOO

DR. SHAILJA TIBREWAL, DR.SOVEETA SOURAVEE RATH, DR. SUMA GANESH

Abstract

Purpose: To study the effect of office Prism Adaptation test (PAT) for uncovering maximum deviation and improving surgical outcomes in intermittent exotropi (IXT). Methods:Retrospective study included basic type IXT patients who underwent preoperative PAT (using Fresnel trial prisms). Horizontal recti surgery was performed for the maximum prism adapted angle. Positive PAT was considered when deviation increased by ≥5PD. Motor success was defined as alignment within 8PD of orthophoria at 6 weeks post-surgery.Results: 19 patients were included. 84.2% were PAT positive. Average increase in deviation was 7.18PD for distance and 10PD for near (p=0.167). Preoperative deviation reduced from 42.17PD to 2.3PD for distance and 46.3PD to 4.3PD for near postoperatively (p value< 0.0001). Motor success was seen in 94.2%. Conclusion: PAT reveals greater preoperative deviation in moderate to large angle IXT.Targeting the prism adapted angle leads to highly successful immediate surgical outcomes.