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Clarke M, Hogan V, Buck D, et al. An external pilot study to test the feasibility of a randomised controlled trial comparing eye muscle surgery against active monitoring for childhood intermittent exotropia [X(T)]. Southampton (UK): NIHR Journals Library; 2015 May. (Health Technology Assessment, No. 19.39.)

Cover of An external pilot study to test the feasibility of a randomised controlled trial comparing eye muscle surgery against active monitoring for childhood intermittent exotropia [X(T)]

An external pilot study to test the feasibility of a randomised controlled trial comparing eye muscle surgery against active monitoring for childhood intermittent exotropia [X(T)].

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Appendix 4Table of excluded studies after full-text review

Study (first author, year)Reason for exclusion
Abbas 197587No separate data for intermittent vs. constant (says in methods section that there are both); no separate data for children (patients aged 2.5–27 years)
Abbasoglu 199688No data for X(T), grouped as exotropia only
Abroms 200189No separate data for children, adults and children mixed (upper age of sample 18.4 ± 16.0 years)
Adams 200890Fewer than 20 cases and data for children and adults mixed
Akar 201291Not all X(T) in case series and only 25 cases of exotropia in total
Akatsuka 200192No separate data for X(T)
Alajbegović-Halimić 200793No data reported separately for X(T), exotropia only
Altizer 197294Sample size, 13 conservative intervention + 16 surgical X(T) remainder XT; interventions – occlusion, convergence exercises, prisms
Ameri 201095Children and adults mixed, also no subgroups so unable to extract X(T) data from other types of squint
Archer 200996No disaggregated data are available for X(T)
Arnoldi 200897Not an intervention study
Asadi 200998Mixed population of adults and children and follow-up only 13.5 weeks
Asjes-Tydeman 200699Effectiveness data not available separately for X(T)
Aslanis 2006100No comparison group
Attarzadeh 2008101No comparison group, case series data only
Awadein 2012102Sample size fewer than 20 patients (only 7 of 25 with A-pattern strabismus including exotropia and esotropia)
Awadein 2008103Sample size fewer than 20 patients with X(T)
Awaya 1982104Sample size fewer than 20 patients with XT [only six patients with X(T)]
Bae 2012105Outcomes not assessing intervention effectiveness
Baker 2008106No comparison group, case series data only
Baker 1979107No comparison group, case series data only
Bansal 2008108Considers adults, no separate data for children
Bao 2006109No comparison group, case series data only
Barraza 2009110Does not consider effectiveness of surgery
Basar 2000111No comparison group, case series data only
Beneish 1994112No comparison group, case series data only
Berard 1979113No comparison group, case series data only
Berard 1979114No intervention comparison group, looks at overcorrected subset only
Berard 1975115No comparison group, case series data only; largely a discursive piece on classification and diagnosis
Berg 1983116Data not presented separately for basic, convergence insufficiency and distance excess
Berland 1998117Sample size fewer than 20 cases of X(T)
Berrondo 1980118Does not include empirical data on effectiveness
Besharati 2008119No data for X(T)
Bietti 1970120Fewer than 20 cases and no mention of X(T) specifically
Billet 1969121No comparison group, case series data only (case reports, n = 11)
Binion 1966122No comparison group, case series data only
Bramante 200956Conference abstract only and no response from study authors
Brandner 2011123No outcomes of interest (not an intervention study)
Brooks 2011124Fewer than 20 patients with exotropia and no mention of X(T)
Broniarczyk-Loba 2003125Mostly adults, no separation of results for children (n = only 25 in total)
Broniarczyk-Loba 1994126ET and XT mixed, no data for X(T) separately
Buck 201225No comparison group, case series data only
Caldeira 2004127Fewer than 20 cases, [looking into cases in detail, only 13 X(T)]
Caltrider 1983128No comparison group (case series data only)
Capo 1989129Constant and intermittent mixed, no separate data for X(T) and n = 24 only in total
Carlton 2011130No intervention or natural history data (explores prevalence of eye disorders, risk factors and relationships with QoL)
Carta 1994131Adults and children in sample, age range 0–32 years, no separate data for children
Cassin 1986132Sample size fewer than 20 patients
Castelbuono 1999133Not addressing outcomes of interest
Castellanos-Bracamontes 1990134Descriptive study, not an intervention study
Celebi 2001135Adults and children mixed, range 4–51 years, no separate data for children
Chae 2008136Recurrent X(T)
Chang 2008137Does not address question of interest
Chang 2006138Data for adults and exotropia generically only (n = 48), no separate data for X(T)
Chia 200649No comparison group, case series data only
Chia 2005139Some patients with convergence insufficiency type and outcomes not reported separately
Cho 2012140No comparison group, case series data only
Cho 2009141Follow-up only 3 months
Cho 2007142No comparison group; mean age 11.4 ± 7.2 years; includes subjects > 18 years (5–19 years)
Choi 2011143No comparison group, case series data only
Choi 2001144Convergence insufficiency subtype
Chryssanthou 1974145Adults and children mixed population age range 5–33 years; data for children not reported separately
Chun 2010146No outcomes of interest
Chun 2008147Recurrent exotropia
Chung 2012148No comparison group, case series data only
Chung 2011149Adults and children mixed, data not reported separately for children
Chutter 1977150Cannot separate out data for adults and convergence insufficiency type
Ciancia 1969151Fewer than 20 patients (n = 15)
Clark 2009152Not X(T) and fewer than 20 patients (n = 8)
Clarke 1981153No comparison group, case series data only
Cooper 1983154Convergence insufficiency type and only seven patients
Cooper 1977155Cannot separate out patients with convergence insufficiency type who represent 11.1% of the sample
Dadeya 2003156No comparison group, case series data only
Dahlmann 2007157Groups differ on basis of condition rather than intervention vs. comparison
Dawson 1999158No intervention comparison group
Debert 2007159No data reported for X(T), only exotropia in general
DeDecker 1988160Adults and children mixed and fewer than 20 patients with X(T)
Deitz 2011161No comparison group, case series data only
DeLianoSanchez 1997162Results not reported separately for X(T)
Demers 1971163Includes convergence insufficiency type
Deng 2009164Fewer than 6 months’ follow-up
Deutsch 1992165Exotropia generally (n = 30) not X(T) subtype
Dong 2006166Exotropia generally not X(T) subtype
Donnelly 2005167Prevalence study with only sparse outcome data for interventions, where n = 10 for exotropia and only five for intermittent divergence excess type
Dzelkaleia 1985168Not an intervention study
Edelman 1988169No comparison group
Ekdawi 2010170Follow-up < 6 months
Ekdawi 200978Data for adults and children mixed (age at time of intervention > 18 years), no separate data for children
El-Defrawi 1970171Not possible to identify X(T) outcome separately
Engel 2004172No separate data for X(T) and no data on initial deviation
Eustace 1972173Fewer than 20 cases with divergent squint
Faridi 2007174Adults and children mixed and no data for children presented separately
Fastrez-Moutschen 1993175Not X(T), exophoric cases only, also case series (no adequate comparison group)
Feretis 1999176No comparison group, case series data only
Fiorelli 2007177Data for adults and children mixed, age range 5–55 years and data not reported separately for children
Friedman 1980178Prevalence study, no intervention
Friemel 1971179No patient outcomes
Gagnon 1970180Adults and children mixed, and no comparison group
Gezer 2004181Outcome data are for intermittent and constant mixed
Gharibyan 2012182Subjects with vertical component (n = 20 only)
Goldrich 1980183Data for adults and children mixed, no separate data for children (n = 28); also unclear how many are X(T)
Goldstein 1968184Sample size fewer than 20 patients and not all X(T)
Gordon 1980185Age range is up to 20 years; also not examining intervention effectiveness, reports on predictor models for surgery
Govekar 1993186No data for X(T) specifically
Govindan 200514Epidemiological study, looking at incidence only; no intervention or follow-up
Graemiger 1979187No patient outcome data on effectiveness
Graf 2002188Comment on an important paper (keep for discussion)
Guo 2011189Case series, no comparison group
Guo 2009190Case series, no comparison group
Gupta 1987191No intervention, considers association of various refractive errors in cases of exophoria
Gusek-Schneider 2006192Children and adults mixed, children and adults (age range 3.1–47.8 years); also minimum range of follow-up period is only 6 weeks
Ha 2011193Adults in sample and some patients with constant or recurrent XT
Haggerty 200471No outcome data on intervention effectiveness
Hahm 2005194Cases of recurrent exodeviation therefore not outcomes from the primary intervention
Hamaguchi 1993195No comparison group, case series data only
Hamtil 1978196Sample size fewer than 20 X(T) (mostly constant)
Hao 2009197No comparison group, case series data only
Hardesty 1983198No comparison group, case series data only (considers those undercorrected or with a recurrence)
Hardesty 1978199No comparison group, case series data only
Hatsukawa 2011200Case series data only, no comparison group
Hatsukawa 1992201No comparison group, case series data only
Hatt 2012202No effectiveness data (conference abstract only)
Hatt 2010203No effectiveness data considers classification only (conference abstract)
Hatt 2007204Not considering intervention effectiveness (before-and-after data for seven patients only)
Herzau 1993205Not considering intervention effectiveness
Hiles 1968206No comparison group, case series data only
Holmes 2010207No comparison group, case series data only
Holtgrave 1973208Not intervention effectiveness
Hu 2012209Adults and children mixed sample, no separate data for children
Huang 2010210No separate outcome data for X(T) and data for adults and children mixed
Hugonnier 1970211No comparison group, case series data only
Hugonnier 1967212No comparison group, case series data only
Hunter 2001213Fewer than 20 cases [n = 7 X(T)]
Iacobucci 1986214No comparison group, case series data only
Inagaki 1993215No comparison group, case series data only and no outcome data to address question of interest
Ing 2011216No comparison group, case series data only
Ing 1999217No comparison group, case series data only
Ing 1986218Constant and intermittent exotropes combined, no separate data for X(T)
Isenberg 2009219No data for X(T) separately and adults/children mixed population
Israel 201157Conference abstract only and no response from study authors
Jacobi 1969220Fewer than 20 cases
Jang 2012221No comparison group, case series data only
Jeoung 2006222RCT but outcome data not available for intermittent and constant exotropes separately
Jojic 1987223Not X(T)
Jung 2012224Not considering intervention effectiveness, no outcomes of interest and follow-up 3 months only
Kamai 200858Conference abstract, have written to study authors but no response
Kang 2011225Only 6-week follow-up
Kampanartsanyakorn 2005226No data for X(T) specifically, refers to exotropia generically only
Kaszli 1997227Reporting on outcomes of surgery for exotropia and esotropia generically with no data on subtypes
Keenan 1994228No comparison group, case series data only
Kertesz 1986229Data for adults and children mixed (age range 4.5–70 years), no outcomes for children separately
Keskinbora 2012230Data for adults and children mixed (range 6–25 years), data for children not reported separately
Khaier 2008231Not X(T)
Kii 1992232No outcomes of interest
Kim 201059Conference abstract only and no response from study authors
Kim 2005233Outcome data not reported separately for adults and children and data for X(T) not reported separately from XT
Kliuka 1987234Not an intervention study
Koklanis 2010235No comparison group, case series data only, all types of X(T) included, no effectiveness data
Koo 2006236No comparison group, case series data only
Kosaki 1967237Not X(T), constant, also no comparison group, case series data only
Kubota 1977238No outcomes of interest, focuses on classification
Kushner 2009239Re-analysis of data from earlier studies
Kushner 1999240Fewer than 20 cases (n = 16, subset of 304 consecutive case series)
Kushner 1999241No outcomes of interest (i.e. no postintervention data for angle of deviation) – rather looks at whether or not myopia is a consequence of overminus lens therapy
Kushner 1998242Does not consider question of interest
Kushner 1993243Cannot separate data for X(T) and constant
Kushner 1989244Fewer than 20 patients [only 17 with X(T)]
Kushner 1988245No comparison group, case series data only
Kutschke 1988246Fewer than 20 patients
Lahlou 1971247Fewer than 20 patients (three cases)
Lak 1997248Deviation is at near for most patients (n = 28) only seven basic type
Lange 2009249Literature review
Lange 1993250Also adults and children mixed, outcome data not available separately for adults and children; cannot separate out divergence excess from convergence insufficiency type
Lee 2012251No comparison group, case series data only
Lee 2012252No comparison group, case series data only
Lee 2011253Fewer than 20 patients who had not previously had surgery (n = 17)
Lee 2009254Not considering intervention effectiveness, no outcomes of interest
Lee 1997255Sample aged up to 21 years at time of intervention and cannot separate data for children; also minimum range of follow-up period is 2 months and mean is 5.3 months
Lennerstrand 1986256Cannot separate data for X(T) from constant exotropia
Leonardi 1993257Adults and children mixed, does not present effectiveness data by age
Leonardi 1970258No effectiveness data (selective group)
Leow 201075No comparison group, case series data only
Lew 2007259Not considering outcomes of interest
Lim 2012260No relevant comparison group for the intervention
Lim 2011261No comparison group, case series data only; also data for adults and children not separate (age range at time of intervention 3–43 years)
Litwinska 1997262Data for exotropia and esotropia not available separately
Livir-Rallatos 2002263Adults and children mixed, cannot separate outcome data for children, also includes constant as well as symptomatic X(T)
Liu 2010264No separate outcome data for X(T)
Liu 2005265Sample size, fewer than 20 cases
Lucas 1994266Sample size, fewer than 20 cases
Marrakchi 1994267No comparison group, case series only
Martin 1989268No comparison group, case series only
Maruo 1988269No comparison group, case series only
Matsusaka 1988270No comparison group, case series only
McNeer 1987271No comparison group, case series only
McSwain 2011272No comparison group, case series only
Melek 1992273Not an intervention study
Menon 2010274Follow-up only 3 months
Metz 1988275Does not identify X(T) separately; considers cases with vertical squint
Miller 1994276Considers only cases of consecutive esotropia after surgery
Mims 2011277Not an intervention study
Mims 2008278Not an intervention study
Mims 2008279No outcomes of interest
Mims 2003280Not the primary intervention
Minguini 2005281No data for X(T) separately
Mitsui 1980282No data for X(T) separately
Mojon 2010283Not examining intervention effectiveness, adults and children in sample and fewer than 20 patients with follow-up
Moore 1977284No intervention data, largely a descriptive piece
Morrison 2010285No comparison group, case series data only, only 2-month follow-up
Morrison 2009286No comparison group, case series data only, only 2-month follow-up
Mumma 1975287Data mixed for adults and children, cannot separate data for children and X(T) from constant exotropia
Nelson 1992288No comparison group, case series data only; also data for adults and children mixed, cannot separate data for children
Nowakowska 2009289No comparison group, case series data only
Nusz 2006290Follow-up period of < 6 months for some patients
Oh 2006291Data for intermittent and constant exotropia mixed, also includes some convergence insufficiency types
Ohtaki 2000292Sample size, fewer than 20 patients with X(T)
Ohtsuki 2001293Cannot separate data for children, mean age 17.8 years, range 4–56 years and sample includes some convergence insufficiency types (n = 39)
Ohtsuki 1997294Data for adults and children mixed, cannot separate data for children
Oleszczynska-Prost 2004295Sample size fewer than 20 cases
Olitsky 1998296No comparison group, case series only
Orlin 2007297Data for exotropia in general, no data for X(T) specifically
Owen 2010298Not assessing intervention effectiveness, considers incidence of adverse effects only
Paakkala 1982299No comparison group, case series only
Pajakowa 1973300No comparison group, case series only
Paris 1998301Sample size fewer than 20 patients
Park 2008302No data for X(T) specifically, XT only
Parkesh 1984303Not X(T)
Patel 1988304Sample size fewer than 20 patients
Paula 2009305No outcomes of interest
Pietruschka 1973306No data for X(T) separately
Pineles 201126Only considers patients with consecutive esotropia
Pineles 201076No relevant comparison group, also, adults in sample and includes convergence insufficiency type
Pineles 2009307No relevant comparison for the interventions (groups differ on the basis of condition rather than on basis of intervention); also data for adults and children mixed
Pratt-Johnson 1979308Follow-up only 1 month
Pratt-Johnson 197784No comparison group, case series only
Qiu 2012309Not examining intervention effectiveness in the long term, considers stereo vision pre and only 1 week postoperatively
Rajavi 2001310Does not report on X(T) specifically (esotropia and exotropia in general)
Remy 1990311Sample size, fewer than 20 cases
Richard 1983312No comparison group, case series only
Rodrigues 2005313Exotropia in general, no specific data for X(T)
Rodrigues 2006314Exotropia in general, no specific data for X(T)
Rohatgi 1982315No comparison group, case series data only
Romanchuk 200636No comparison group, case series data only
Ron 1985316No separate data for X(T)
Roth 1981317No comparison group, case series only
Rowe 200944No separate data for X(T), as data for adults and children mixed (range 1–79 years)
Rowe 1990318Sample size fewer than 20 patients
Rutstein 2003319No separate data for children, also outcomes for convergence insufficiency mixed with basic and divergence excess types
Rutstein 1989320No outcomes of interest and no comparison group (case series data only)
Ruttum 199773No comparison group, case series data only, also data for adults and children mixed
Santos 2011321Sample size fewer than 20 patients with exotropia and no mention of X(T)
Saxena 2011322Adults in sample, no separate data for children only
Schulz 1984323No comparison group, case series only
Schwartz 1980324No data for X(T) separately and adults and children mixed population
Scott 1990325Does not separate X(T) from exotropia in general
Scott 1975326Sample age fewer than 20 patients
Segal 2000327Not data for X(T) specifically
Self 2004328No data for X(T) specifically
Sethi 2008329No data on intervention effectiveness
Shippman 1979330Follow-up < 6 months
Siatkowski 2010331Not an intervention study
Singh 1992332Children and adults mixed, no separate data for children, also some cases of convergence insufficiency cases included
Smoot 1990333Sample size fewer than 20 patients, subgroup of overcorrected ET and n = 9
Somer 2007334Convergence insufficiency type
Spencer 199722No comparison group data reported
Spielmann 1983335Adults and children mixed and no mention of X(T) specifically
Spierer 2010336No data for X(T) separately
Spierer 2005337No data for X(T) separately, also adults and children mixed population
Spoor 1979338Not X(T)
Stoller 1994339No separate data for X(T) and adults and children mixed
Strogal 1983340No comparison group, case series only
Stuteville 2007341No intervention and adults
Suh 2006342Follow-up < 6 months
Sun 2010343No data reported for X(T) separately
Tae 2005344No comparison group data on effectiveness, also adults and children mixed
Tao 2008345No data for X(T) separately, adults and children mixed
Tatham 2009346Data for adults and children mixed, also no data for X(T) separately
Thouvenin 2008347Not X(T)
Tibbs 1978348Sample size fewer than 20 patients with X(T)
Tsuji 1988349No separate data for X(T)
Usui 2000350No comparison group, case series only
Vishnoi 1987351Adults and children mixed, no separate data for children
Wang 2010352No comparison group, case series only
Wang 2009353No comparison group, case series data only
Wang 2008354No comparison group, case series only
Weakley 1993355No separate data for X(T) and adults and children mixed
Weston 1991356Outcomes for XT generally (n = 34), no data for X(T) specifically
Wickens 1984357No comparison group, case series only
Wilson 1989358No effectiveness data for X(T)
Windsor 1971359Follow-up < 6 months
Wu 2007360No comparison group, case series only
Wu 2006361No comparison group, case series only
Wutthiphan 2008362Data for adults and children mixed
Wygnanski-Jaffe 1999363No data for X(T) specifically only XT and ET generally
Xu 2012364Not intervention effectiveness, focuses on adults
Yam 2012365No comparison group, case series only
Yan 2006366No mention of X(T) specifically
Yang 2008367No comparison group, case series only
Yang 1984368Follow-up only 6 weeks
Yao 1993369No comparison group, case series data only
Yazdian 2006370Sample size fewer than 20 patients
Yi 2011371No data for X(T) separately, pools exotropia and esotropia and includes consecutive as well as primary cases
Yildirim 1999372Adults and children mixed sample, no data for children separately
Yin 2002373Data for adults and children mixed
Yu 1989374No comparison group, case series data only
Zaki 1972375No intervention, descriptive epidemiological data on prevalence of types of XT
Zhi 2008376No specific data on X(T) discusses XT only
Zibrandtsen 1986377Sample size fewer than 20 patients with basic or divergence excess type X(T)
Ziegler 1982378Review, no empirical data
Copyright © Queen’s Printer and Controller of HMSO 2015. This work was produced by Clarke et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

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Bookshelf ID: NBK294402
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