Long-term outcomes following resection-recession versus plication-recession in children with intermittent exotropia

2019 ◽  
Vol 104 (3) ◽  
pp. 350-356 ◽  
Author(s):  
Haeng-Jin Lee ◽  
Seong-Joon Kim
Keyword(s):  
Surgical Outcomes ◽  
Lateral Rectus ◽  
Medial Rectus ◽  
Clinical Factors ◽  
Long Term Outcomes ◽  
Intermittent Exotropia ◽  
Surgical Success ◽  
Angle Of Deviation

Background/AimsTo compare the long-term surgical outcomes between unilateral lateral rectus recession-medial rectus resection (RR) and lateral rectus recession-medial rectus plication (RP) in children with intermittent exotropia.MethodsChildren who underwent RR or RP for intermittent exotropia between January 2008 and July 2016, with a minimum follow-up period of 2 years were retrospectively reviewed. Postoperative angle of deviations and clinical factors including sex, age, refractive errors, preoperative angle of deviation, types of exotropia and stereopsis were investigated. Based on the angle of deviation at year 2, surgical outcomes were classified into two groups as follows: success (esodeviation ≤5 prism dioptres (PD) to exodeviation ≤10 PD) and failure (overcorrection (esodeviation >5 PD) and undercorrection or recurrence (exodeviation >10 PD)).ResultsOf the 186 patients, 114 underwent RR and 72 underwent RP. The angle of exodeviation steadily increased over time in both groups after surgery. The durations of exodrift were longer in the RP group than in the RR group. The surgical success at postoperative year 2 was 55.3% in the RR group and 27.8% in the RP group (p<0.001). The amount of overcorrection was associated with successful outcomes in both groups.ConclusionsIn children with intermittent exotropia, RR group presented better surgical outcomes than RP group. The amount of initial overcorrection was important to achieve favourable outcomes in children with intermittent exotropia.

Surgical outcomes according to distance between preplaced suture and muscle insertion in lateral rectus recession

2017 ◽  
Vol 28 (3) ◽  
pp. 253-258
Author(s):  
Ki W. Jin ◽  
Yoon P. Lee ◽  
Dong G. Choi
Keyword(s):  
Success Rate ◽  
Surgical Outcomes ◽  
Lateral Rectus ◽  
Secondary Outcome ◽  
Dose Ratio ◽  
Surgical Success ◽  
Muscle Insertion ◽  
Angle Of Deviation ◽  
The Mean

Purpose: To compare surgical outcomes according to the distance between the preplaced suture and the muscle insertion in lateral rectus (LR) recession for exotropia. Methods: We retrospectively reviewed 64 patients who had undergone unilateral LR recession by one right-handed surgeon and divided the patients into 2 groups: right LR recession (R group, 26 patients) and left LR recession (L group, 38 patients). In the R group, the preplaced suture was behind the hook, far from the insertion; in the L group, the suture was in front of the hook, near the insertion. The main outcome measures were postoperative alignment and surgical success rate and the secondary outcome measure was effect/dose ratio. Surgical success was defined as an alignment between 10 prism diopters (PD) of exodeviation and 5 PD of esodeviation both at distance and at near. The effect/dose ratio was defined as the corrected angle of deviation at postoperative 6 months divided by the amount of LR recession. Results: The mean angle of deviation at distance showed a significant difference between the groups at postoperative 3 months (p = 0.022), but not at final follow-up (p = 0.163). There was no difference between the groups in the mean angle of deviation at near postoperatively. Surgical success was achieved in 73.1% of the R group and 71.1% of the L group at final follow-up, which was not significant (p = 0.860). Conclusions: The distance between the preplaced suture and the muscle insertion in LR recession did not affect the surgical success rate or the postoperative alignment at final follow-up.

scholarly journals Surgical Outcomes of Unilateral Lateral Rectus Recession Versus Recess-resect in Children With Small-to-medium Angle Convergence Insufficiency-type Intermittent Exotropia

2021 ◽  
Author(s):  
Yoon Kyung Jang ◽  
Seok Hyun Bae ◽  
Dong Gyu Choi
Keyword(s):  
Surgical Outcomes ◽  
Medical Records ◽  
Lateral Rectus ◽  
Intermittent Exotropia ◽  
Surgical Success ◽  
Convergence Insufficiency ◽  
Significant Difference ◽  
Distance Difference ◽  
The Mean

Abstract To determine the efficacy of unilateral lateral rectus recession (ULR) for convergence insufficiency-type intermittent exotropia (CI-type IXT), we compared surgical outcomes following ULR and recess‒resect (RR) procedures for CI-type IXT. In this retrospective study, medical records of 57 children who underwent ULR (n = 30) or RR (n = 27) for CI-type IXT of less than 25 PD at distance with a postoperative follow-up of 6 months or more were reviewed. Surgical success was defined as an alignment between 10 PD exodeviation and 5 PD esodeviation at distance and near fixation. The postoperative exodeviation showed no significant difference between the two groups at the last follow-up. A significant reduction in the mean near-distance difference was achieved postoperatively in both groups: from 5.4 PD preoperatively to 2.5 at last follow-up after ULR, and from 8.2 to 2.4 after RR (both p = 0.001). However, this difference between ULR and RR was not statistically significant (p > 0.05). The success rate at the last follow-up was 63.3% for ULR and 70.4% for RR (p = 0.574). ULR was found to be an effective treatment for CI-type IXT, with similar surgical outcomes to RR.

scholarly journals Long term surgical outcomes of unilateral recession-resection versus bilateral lateral rectus recession in basic-type intermittent exotropia in children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dong Hyun Kim ◽  
Hee Kyung Yang ◽  
Jeong-Min Hwang
Keyword(s):  
Age Of Onset ◽  
Basic Type ◽  
Lateral Rectus ◽  
Long Term Results ◽  
Intermittent Exotropia ◽  
Younger Age ◽  
Significant Difference ◽  
Type Of Surgery

AbstractThe long-term results of surgical treatment of intermittent exotropia (X(T)) according to the type of surgery are controversial. We conducted a retrospective cohort study to compare the long-term results between unilateral recession-resection (RR) and bilateral lateral rectus recession (BLR) with an average follow-up of 9.5 years in children with basic-type X(T). Patients with basic-type X(T), who underwent RR (RR group) or BLR (BLR group) and were followed-up for more than 5 years postoperatively, were analyzed. Of the 560 patients, 363 patients received BLR and 197 patients underwent RR. There was no significant difference in the success rates between the two groups until postoperative 3 years. At an average of 9.5 ± 2.6 years after surgery, the success rate of the RR group was significantly higher than that of the BLR group starting from the fourth post-operative year until the last follow-up examination (64.5% vs 43.3%, P < 0.001). By multivariate analysis, preoperative hyperopia of more than + 2.00 diopters, younger age of onset, younger age at surgery, larger exodeviation at near than at distance of > 5 prism diopters, and the type of surgery (BLR) were risk factors of recurrence. In conclusion, RR was more successful than BLR with a lower recurrence rate in the long-term follow-up of patients with basic-type X(T).

Lateral rectus advancement versus medial rectus recession for consecutive esotropia

2019 ◽  
pp. 112067211987009 ◽  
Author(s):  
Masoud Aghsaei Fard ◽  
Hossein Ghahvehchian
Keyword(s):  
Success Rate ◽  
Lateral Rectus ◽  
Medial Rectus ◽  
Intermittent Exotropia ◽  
Chi Square ◽  
Similar Measure ◽  
Second Surgery ◽  
Group Success ◽  
Consecutive Esotropia

Purpose: To compare lateral rectus advancement with medial rectus recession for patients with consecutive esotropia without abduction limitation. Methods: Forty-three patients who developed consecutive esotropia following bilateral lateral rectus recession for intermittent exotropia were reviewed retrospectively. Twenty-two patients underwent lateral rectus advancement (lateral rectus advancement group) and medial rectus recession was performed in 21 patients (medial rectus recession group). Success rate of the surgery was based on the percentage of postoperative esophoria or exophoria of less than 8 PD, which did not require a third surgery. Mean follow-up after second surgery was 23.5 ± 8.7 months. Results: Mean consecutive esotropia in the lateral rectus advancement group was 24.8 ± 9.0 PD. Eight patients were orthophoric after second surgery; mean postoperative esophoria and exophoria/tropia was 5.4 ± 3.4 PD and 6.5 ± 5 PD, respectively. Postoperative success rate in this group was 90.9%. Mean consecutive esotropia in the medial rectus recession group was 21 ± 98.4 PD. Three patients were orthophoric after second surgery; mean postoperative esotropia/phoria and exophoria was 9.5 ± 5.0 PD and 5.2 ± 1.3 PD, respectively. Postoperative success rate in this group was 71.4%. Postoperative undercorrection rate of 4.5% in lateral rectus advancement group was significantly less than the similar measure of 28.6% in medial rectus recession group (chi-square, P = 0.03). Conclusion: Advancement of the previously recessed lateral rectus has improved consecutive esotropia better than medial rectus recession.

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