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

Kim, Joo Hyun; Kim, Hae Jin; Choi, Dong Gyu

doi:10.1136/bjophthalmol-2013-303171

Cited by 13 publications

(11 citation statements)

References 17 publications

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“…Controversies partly stem from the highly variable surgical success rate in the published literature, ranging from 42 to 81%. [4][5][6][7][8][9] To evaluate the success of IXT surgery, functional outcomes are emphasized, [5][6][7][10][11][12][13][14][15][16][17][18][19] as well as motor alignment after surgery; however, few studies have considered functional outcomes for evaluating surgical success. 5,7,10 Several studies have investigated factors that possibly affect surgical outcomes, including refractive errors.…”

Section: Introductionmentioning

confidence: 99%

Hyperopic refractive errors as a prognostic factor in intermittent exotropia surgery

et al. 2015

Eye

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Purpose To evaluate and compare surgical outcomes with respect to refractive errors in strabismus surgery for the treatment of intermittent exotropia (IXT). Methods The medical records of patients with IXT who were treated by one surgeon from January 2005 and June 2011 were reviewed. Three hundred and thirty-three IXT patients were included and divided into three groups according to preoperative refractive error: IXT with hyperopia (group I), IXT with emmetropia (group II), and IXT with myopia (group III). The surgical outcomes with respect to sensory and motor criteria were compared among the three groups. Results The surgical success rates according to motor criteria and sensory and motor criteria combined were higher in groups I (29 patients) and III (124 patients) than in group II (180 patients) at postoperative 3 and 6 months and at the last follow-up. Stereopsis was significantly better in groups II and III than in group I preoperatively (P = 0.002 by one-way analysis of variance test); however, the difference was not significant postoperatively. Twenty patients in group I (69.0%) were prescribed undercorrected hyperopic spectacles postoperatively, while only 22 patients in group III (17.7%) were prescribed spectacles with more myopic power than their refractive errors. Conclusion In the surgical treatment of IXT, hyperopia was not an indicator of poor prognosis. Taking into consideration the age effect, follow-up period after IXT surgery, and stereopsis improvement, hyperopic refractive error is rather a good prognostic factor.

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Section: Introductionmentioning

confidence: 99%

Hyperopic refractive errors as a prognostic factor in intermittent exotropia surgery

et al. 2015

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“…There are some reports concerning the success rates achieved using different surgical techniques. Kim et al24 compared the results of contralateral ULR recession after unilateral R&R with those of contralateral R&R after unilateral R&R. The final angle deviation was similar between the two groups, but they recommended ULR recession because it reduces the immediate postoperative overcorrection. In our study, we could not determine the surgical method that would achieve the best result.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with the Prognosis after Operation in Children with Recurrent Intermittent Exotropia

Kim

2019

J Korean Med Sci

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BackgroundTo describe factors affecting the prognosis after operation for recurrent intermittent exotropia (X[T]) in children.MethodsClinical records of 50 patients who underwent operation for recurrent X(T) by a single surgeon were reviewed. The age at diagnosis of X(T), and first and second operations, deviation angle at distance and near, surgical method, concurrent vertical strabismus, stereoacuity, and Worth's Four Dot (W4D) examination before reoperation were analyzed, along with the postoperative deviation angle. A successful surgical outcome was defined as orthophoria, esodeviation ≤ 5 prism diopters, or exodeviation ≤ 10 prism diopters at distance.ResultsAmong the 50 recurrent exotropes who underwent surgery and were followed up for more than 1 year postoperatively, 13 showed recurrent exotropia and 1 showed consecutive esotropia. The mean age at reoperation was 8.49 ± 2.19 years, and the mean duration of postoperative follow-up was 27.78 ± 12.02 months. Good near fusion before reoperation was a significant factor in the success of surgery (P = 0.006). Smaller postoperative deviation angle measured immediately and 2 months after surgery were related to smaller final deviation angle (P = 0.027 and P = 0.022, respectively).ConclusionPeripheral suppression lowers the success rate of operation for recurrent X(T) in children. Overcorrection rather than orthotropia should be the target of immediate postoperative deviation angle. Peripheral suppression status and immediate and 2-month postoperative deviation angle may be important clues for predicting the final result of operation for recurrent X(T).

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“…To achieve a satisfactory ocular alignment and maintain binocular function, patients with recurrent exotropia usually undergo an additional operation [2-8, 10]. Surgical interventions for recurrent exotropia depend on the previous surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical options for patients who have undergone bilateral medial rectus resection (BMR) include bilateral medial rectus re-resection, unilateral lateral rectus recession and medial rectus re-resection, and bilateral lateral rectus recession (BLR). However, rectus muscle reoperation has disadvantages because it is a more difficult surgical technique due to scar tissues, it requires more time under anesthesia, and it has a higher risk of limited ocular rotation [4, 10]. Therefore, BLR, as the secondary operation, may achieve satisfactory results for this condition.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Lateral Rectus Recession for the Treatment of Recurrent Exotropia after Bilateral Medial Rectus Resection

2018

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Purpose: To evaluate the efficacy of bilateral lateral rectus muscle recession (BLR) to treat recurrent exotropia after bilateral medial rectus muscle resection (BMR). Methods: Twenty-four patients who underwent BLR for recurrent exotropia and were followed up for more than 6 months were included in this retrospective study. All of them had prior BMR. The angle of deviation, success rates, near stereopsis, and surgical effect of BLR were evaluated. Surgical success was defined as postoperative deviations ≤10 prism diopters (PD). Results: The overall mean follow-up time after reoperation for patients was 24.13 ± 15.01 months (range 6–60 months). The mean angle of deviation at distance was significantly reduced from –37.75 ± 14.93 PD to +1.50 ± 6.43 PD (p < 0.001). Twenty-two (91.6%) of 24 patients had successful outcomes, 1 (4.2%) had overcorrection, and 1 (4.2%) had undercorrection at the last follow-up. Improved stereopsis after reoperation was observed in 78.3% (18/23) of the patients. The mean surgical effect was 2.78 ± 0.71 PD/mm. Conclusion: Based on our results, BLR could be an effective and safe method for treating recurrent exotropia after a moderate to large amount of BMR.

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

Abstract: Contralateral LR recession was found to be a safe and effective procedure for the treatment of recurrent exotropia of 20-25 PD after unilateral RR for intermittent exotropia. With LR recession, the intentional overcorrection in the immediate postoperative period could be avoided.

Cited by 13 publications

References 17 publications

Hyperopic refractive errors as a prognostic factor in intermittent exotropia surgery

Hyperopic refractive errors as a prognostic factor in intermittent exotropia surgery

Factors Associated with the Prognosis after Operation in Children with Recurrent Intermittent Exotropia

Bilateral Lateral Rectus Recession for the Treatment of Recurrent Exotropia after Bilateral Medial Rectus Resection

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