Surgical management of consecutive exotropia: Long-term outcomes

Abstract

Purpose: To compare lateral rectus recession (LRc) and medial rectus advancement (MRadv) for correction of consecutive exotropia (CXT). Methods: Of the 43 exotropic patients 20 of them underwent LRc (group 1) and 23 of them underwent MRadv (group 2). Postoperative exodrift, strabismic angle, dose effect relationship were compared with minimum 2 years follow‑up. Results: An average dose-effect in group 2 is higher than group 1 in the early postoperative period, however there was no significant difference at the second year follow-up (p=0,109). An average exodrift after 2 year follow-up was 6,6±7,12 PD in group 1, and 8,13±7,45 PD in group 2. Postoperative overall success rate was 50% in group 1 and 65% in group 2 at the last follow-up. The success rates were not significantly different between the groups (chi-square, p =0.31). Conclusion: Although there was no statistically significant difference at the last follow-up, better results were obtained with MRadv than LRc in the treatment of CXT.

Bilateral Medial Rectus Advancement versus Unilateral Medial Rectus Advancement with Lateral Rectus Recession for Surgical Management of Large Angle Consecutive Exotropia without Adduction Deficit

“… 17 Similarly, Ceylan et al reported 69% successful results when they studied 23 patients with a low preoperative angle of deviation (25.48 PD for distance and 24.39 PD for near). 25 Also, Cho and Ryu operated 38 patients with a 25.6 PD mean preoperative angle of deviation and reported a 79% success rate. 26 …”

“…Both Donaldson et al and Ceylan et al found no statistically significant difference in success rates between amblyopic and non-amblyopic patients. 22 , 25 …”

“…From the previous reports, we noticed that the bilateral medial rectus advancement technique was more effective at a small angle of deviation than at a large one. 17 , 25 , 26 …”

“…26 In group I, the mean dose-effect relationship at the end of the follow-up period was 2.62 PD/mm, which is closer to that reported by Kasi et al (2.3 PD/mm), Ceylan et al (2.8 PD/mm) and Cho and Ryu (2.9 PD/mm). [24][25][26] Amblyopia was present in 22% of under-corrected patients in group I, but it was statistically insignificant when compared to under-corrected patients in the same group who did not have amblyopia (p = 0.169). Both Donaldson et al and Ceylan et al found no statistically significant difference in success rates between amblyopic and non-amblyopic patients.…”

“…17 Similarly, Ceylan et al reported 69% successful results when they studied 23 patients with a low preoperative angle of deviation (25.48 PD for distance and 24.39 PD for near). 25 Also, Cho and Ryu operated 38 patients with a 25.6 PD mean preoperative angle of deviation and reported a 79% success rate. 26 In group I, the mean dose-effect relationship at the end of the follow-up period was 2.62 PD/mm, which is closer to that reported by Kasi et al (2.3 PD/mm), Ceylan et al (2.8 PD/mm) and Cho and Ryu (2.9 PD/mm).…”