Selective Surgery for Intermittent Exotropia Based on Distance/Near Differences

Abstract

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. Objectives: To evaluate the appropriateness of selective surgery based on distance/near differences and to determine if bilateral lateral rectus recessions affect the distance deviation more than the near deviation. Patients and Methods: Patients with basic type intermittent exotropia were randomized to 2 groups, those receiving either unilateral recess/resect procedures or symmetric lateral rectus recessions. Patients with simulated divergence excess intermittent exotropia received symmetric lateral rectus recessions. Outcome was observed 1 year after surgery. Results: Of 19 patients with basic exotropia receiving lateral rectus recessions, 10 patients (52%) had a satisfactory outcome compared with 14 (82%) of the 17 pa

Comparison of bilateral lateral rectus recession and unilateral recession resection for basic type intermittent exotropia in children

“…The success rate in patients with basic type IXT who had undergone BLR-rec and R&R procedures was 65.8% (25/38) and 85.1% (40/47), respectively, after a mean follow-up of 14.8±9.5 months. The results of this study are in agreement with the Kushner4 and Audery7 studies that R&R is more effective than BLR-rec. Furthermore, the undercorrection rate in patients who had undergone BLR-rec was 23.7% (9/38) in our study, similar to Fiorelli's result of 28.6%6 and Choi's result of 21.8% (1-year follow-up),8 but lower than Audery's result of 56% 7.…”

Comparison of bilateral lateral rectus recession and unilateral recession resection for basic type intermittent exotropia in children

“…The success rate in patients with basic type IXT who had undergone BLR-rec and R&R procedures was 65.8% (25/38) and 85.1% (40/47), respectively, after a mean follow-up of 14.8±9.5 months. The results of this study are in agreement with the Kushner4 and Audery7 studies that R&R is more effective than BLR-rec. Furthermore, the undercorrection rate in patients who had undergone BLR-rec was 23.7% (9/38) in our study, similar to Fiorelli's result of 28.6%6 and Choi's result of 21.8% (1-year follow-up),8 but lower than Audery's result of 56% 7.…”

Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia

“…Findings in our study agree with those of previous studies 18-23. Distance stereoacuity in patients with X(T) was found to be very poor and surgical realignment led to improvement in distance stereoacuity 24.…”

Comparative Study of Unilateral Recession Resection Versus Bilateral Recession in Intermittent Exotropia

“…The procedure of choice for intermittent exotropia is considered to be bilateral lateral rectus recession in divergence excess type and unilateral lateral rectus recession and medial rectus resection in basic type. 10 In our study the mean age of the patients was 18.7 years which was similar to the study conducted by Myogo et al 11 The high average age at the time of surgery could be attributed to lack of awareness and fear of surgery. The earliest age at which surgical intervention should be done in intermittent exotropia has been subject of much debate.…”

Comparison of bilateral lateral rectus recession and unilateral recession resection for basic type intermittent exotropia in children

“…The success rate in patients with basic type IXT who had undergone BLR-rec and R&R procedures was 65.8% (25/38) and 85.1% (40/47), respectively, after a mean follow-up of 14.8±9.5 months. The results of this study are in agreement with the Kushner4 and Audery7 studies that R&R is more effective than BLR-rec. Furthermore, the undercorrection rate in patients who had undergone BLR-rec was 23.7% (9/38) in our study, similar to Fiorelli's result of 28.6%6 and Choi's result of 21.8% (1-year follow-up),8 but lower than Audery's result of 56% 7.…”

Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia

“…Findings in our study agree with those of previous studies 18-23. Distance stereoacuity in patients with X(T) was found to be very poor and surgical realignment led to improvement in distance stereoacuity 24.…”

Comparative Study of Unilateral Recession Resection Versus Bilateral Recession in Intermittent Exotropia

“…The procedure of choice for intermittent exotropia is considered to be bilateral lateral rectus recession in divergence excess type and unilateral lateral rectus recession and medial rectus resection in basic type. 10 In our study the mean age of the patients was 18.7 years which was similar to the study conducted by Myogo et al 11 The high average age at the time of surgery could be attributed to lack of awareness and fear of surgery. The earliest age at which surgical intervention should be done in intermittent exotropia has been subject of much debate.…”

Comparison of bilateral lateral rectus recession and unilateral recession resection for basic type intermittent exotropia in children

“…The success rate in patients with basic type IXT who had undergone BLR-rec and R&R procedures was 65.8% (25/38) and 85.1% (40/47), respectively, after a mean follow-up of 14.8±9.5 months. The results of this study are in agreement with the Kushner4 and Audery7 studies that R&R is more effective than BLR-rec. Furthermore, the undercorrection rate in patients who had undergone BLR-rec was 23.7% (9/38) in our study, similar to Fiorelli's result of 28.6%6 and Choi's result of 21.8% (1-year follow-up),8 but lower than Audery's result of 56% 7.…”

Evaluation of distance and near stereoacuity and fusional vergence in intermittent exotropia

“…Findings in our study agree with those of previous studies 18-23. Distance stereoacuity in patients with X(T) was found to be very poor and surgical realignment led to improvement in distance stereoacuity 24.…”

Comparative Study of Unilateral Recession Resection Versus Bilateral Recession in Intermittent Exotropia

“…The procedure of choice for intermittent exotropia is considered to be bilateral lateral rectus recession in divergence excess type and unilateral lateral rectus recession and medial rectus resection in basic type. 10 In our study the mean age of the patients was 18.7 years which was similar to the study conducted by Myogo et al 11 The high average age at the time of surgery could be attributed to lack of awareness and fear of surgery. The earliest age at which surgical intervention should be done in intermittent exotropia has been subject of much debate.…”