Comparison of Outcomes of Unilateral Lateral Rectus Recession for Exotropia between First and Second Operations

Choi

2013

Br J Ophthalmol

Section: Discussionmentioning

confidence: 99%

“…Lee et al 19 reviewed the outcomes of 15 patients with recurrent exotropia of 15–20 PD who underwent unilateral LR recession as a secondary operation. At the final follow-up, nine (60%) of the 15 subjects showed alignment within 10 PD, a result similar to ours.…”

Section: Discussionmentioning

confidence: 99%

Contralateral lateral rectus recession versus recess–resect for recurrent exotropia after unilateral recess–resect

Choi

2013

Br J Ophthalmol

“…Moreover, several authors have reported, for this procedure, a low rate of overcorrection, which lowers the risk of developing amblyopia and the consequent loss of binocular vision [ 8 , 13 ]. Recently, it was reported that ULR can lead to similar results between the first and second operations for exotropia of 15 to 20 PD [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of unilateral lateral rectus recession versus recess-resect for intermittent exotropia of 20-25 prism diopters

Choi

2014

BMC Ophthalmol

BackgroundThe 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).MethodsIn 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 more. The main outcome measures were postoperative exodeviation angles and final success rates. A surgical success was considered to be an alignment within 10 PD.ResultsThe mean follow-up duration after the surgery was 53.8 ± 26.4 months in the ULR group and 52.5 ± 27.4 months in the RR group (p = 0.482). The mean deviation angles at postoperative 1 day were -0.49 PD (esodeviation) in the ULR group and -1.98 PD in the RR group. Subsequently, at postoperative 1 week, 1 and 3 months, the deviations became more exotropic in the ULR group than in the RR group (p < 0.05). However, the mean deviation angles at 6 months, 1 and 2 years and at the final follow-up did not significantly differ between the two groups. Surgical success at the final follow-up was achieved for 50 patients (60.9%) in the ULR group and 55 patients (56.1%) in the RR group (p = 0.511).ConclusionsULR is an effective surgical method for treatment of moderate-angle intermittent exotropia of 20-25 PD, showing results similar to those of RR.

“…Weakley and Stager [ 2 ] suggested guidelines for ULR muscle recession. Comparing recurrent XT patients with exodeviation under 15 to 20 PD who underwent unilateral lateral recession as a first surgery with those who underwent it as second surgery, the authors reported that there was no significant difference in the success rate between groups at 92.9% and 90.0%, respectively [ 13 ]. That study also recommends ULR surgery as a second surgery for patients with recurrent XT, but is different from our study in that its findings about the first surgeries for patients with recurrent XT are variable and inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Postoperative Exodrift after First Unilateral and Second Contralateral Lateral Rectus Recession in Recurrent Exotropia

Lee

et al. 2016

Korean J Ophthalmol

PurposeTo compare postoperative exodrift of the first unilateral lateral rectus (ULR) muscle recession with the exodrift of the second contralateral ULR muscle recession in patients with recurrent small-angle exotropia (XT).MethodsWe evaluated the results of a second ULR muscle recession in 19 patients with recurrent XT with deviation angles under 25 prism diopter (PD), following a first procedure of ULR muscle recession for small-angle XT. Recession of the lateral rectus muscle ranged from 8 to 9 mm. The postoperative motor alignment and degree of exodrift were investigated after the first ULR muscle recession and the second ULR muscle recession in the same patients.ResultsObserved differences in postoperative ocular alignment between the first ULR muscle recession and the second ULR muscle recession were statistically significant at follow-up periods of six months (7.84 ± 4.43 vs. 3.89 ± 3.47 PD), one year (9.58 ± 4.97 vs. 5.21 ± 4.94 PD), and at a final follow-up (21.11 ± 2.98 vs. 7.52 ± 4.06 PD) after surgery (p = 0.006, 0.013, and 0.000). Postoperative exodrift was statistically different between the first and second ULR muscle recessions at three to six months (2.89 ±3.75 vs. 0.63 ± 3.45 PD) and one year to final follow-up (11.52 ± 5.50 vs. 2.32 ± 3.53 PD) (p = 0.034 and 0.000). All of the first ULR muscle recession patients showed XT with deviation angles of more than 15 PD at the final follow-up. Regardless, the surgical success rate (<8 PD) after the second ULR recession was 63.16% (12 patients) among the total amount of patients with recurrent XT.ConclusionsThis study shows that changes in exodrift after a second ULR muscle recession are less than changes after the first URL muscle recession among patients with recurrent XT. A second ULR muscle recession may be a useful surgery for small-angle XT patients with deviation angles of 25 PD or less after a first ULR muscle recession.