Long-term outcomes of augmented unilateral recess-resect procedure in children with intermittent exotropia
نویسندگان
چکیده
BACKGROUND Initial overcorrection after exotropia surgery has been considered as a desirable result. Recently, there had been several studies that reported better surgical results of augmented bilateral lateral rectus muscle recession procedure over the conventional procedure. OBJECTIVES To compare the long-term results of augmented unilateral lateral rectus recession-medial rectus resection procedure (RR) with the original surgery in exotropic children. DATA EXTRACTION A retrospective cohort study was performed on a total of 121 children with exotropia who underwent RR from February 2005 to December 2012 and were followed-up for at least 24 months. In 64 patients, RR was performed based on the original surgical table (original RR group). In 57 patients, the amount of medial rectus muscle resection was increased by 1 mm (augmented RR group). RESULTS In the original RR group, 47 of 64 patients (73.4%) had a successful outcome, 13 patients (20.3%) had recurrence, and 4 patients (6.3%) had overcorrection at 2 years after surgery. In the augmented RR group, 45 of 57 patients (79.0%) were successful, 4 patients (7.0%) had recurrence and 8 patients (14.0%) had overcorrection at 2 years after surgery. The recurrence rate was significantly lower in the augmented RR group than the original RR group, whereas the overcorrection rate was not significantly different between two groups at 2 years after surgery (P = 0.036 and P = 0.153, respectively). The cumulative probability of recurrence was lower in the augmented group at 36 months after surgery (P = 0.046, log rank test). CONCLUSIONS The long-term success rate of augmented RR in exotropic children was 79.0% and the recurrence rate was significantly lower than original RR with comparable overcorrection rates. Augmented RR can be considered as an alternative procedure in children with basic and convergence insufficiency type exotropia.
منابع مشابه
Comparison of long-term surgical outcomes of 2-muscle surgery in children with large-angle exotropia: bilateral vs unilateral.
PURPOSE To evaluate the long-term results of 2-muscle surgery in children with primary large-angle exotropia, comparing 10 mm bilateral lateral rectus recession (BLR) with unilateral lateral rectus recession-medial rectus resection (recess/resect). DESIGN Retrospective case series. METHODS Eighty-six children with exotropia of ≥40 prism diopters (PD), who underwent the 10 mm BLR (BLR group)...
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BACKGROUND The purpose of this study was to compare surgical outcomes of unilateral lateral rectus recession (ULR) and unilateral recess-resect (RR) for intermittent exotropia of 20-25 prism diopters (PD). METHODS In this retrospective study, ULR was performed on 82 patients and RR on 98 patients for the treatment of intermittent exotropia of 20-25 PD with a follow-up period of 24 months or m...
متن کاملIntermittent exotropia: comparative surgical results of lateral recti-recession and monocular recess-resect.
PURPOSE To compare the results between recession of the lateral recti and monocular recess-resect procedure for the correction of the basic type of intermittent exotropia. METHODS 115 patients with intermittent exotropia were submitted to surgery. The patients were divided into 4 groups, according to the magnitude of preoperative deviation and the surgical procedure was subsequently performed...
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BACKGROUND Classic teaching suggests that surgery for intermittent exotropia should be based on distance/near differences. Divergence excess, according to tradition, should be treated with symmetric lateral rectus recessions; simulated divergence excess and basic deviations should be treated with a recess/resect procedure. This teaching, to our knowledge, has not been systematically tested. O...
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PURPOSE To compare the long-term surgical outcomes of augmented bilateral lateral rectus (LR) recession with original surgery. DESIGN Retrospective, nonrandomized clinical study. METHODS A total of 447 children with ≤35 prism diopters (PD) of basic and divergence excess-type intermittent exotropia, who underwent original bilateral LR recession based on the largest angle measured at distance...
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