The advancement of the medial rectus muscle for consecutive exotropia

Cho, Yoonae A.; Ryu, Won Yeol

doi:10.1016/j.jcjo.2013.03.003

Cited by 29 publications

(60 citation statements)

References 25 publications

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“…5,6,9 In the current study, linear regression fit both early and late surgical effects reasonably well. In each time period, there was a regression slope of about 4 Δ of exotropia correction per mm of medial rectus advancement; this represents the incremental effect of a change in surgical dose.…”

Section: Discussionsupporting

confidence: 65%

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Consecutive exotropia: why does it happen, and can medial rectus advancement correct it?

Leon

Demer

2014

Journal of American Association for Pediatric Ophthalmology and

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Purpose To investigate whether consecutive exotropia following medial rectus muscle recession is associated with muscle slippage and to assess the effectiveness of treating the condition with medial rectus advancement. Methods The records of patients with consecutive exotropia after medial rectus recession were reviewed to determine medial rectus muscle insertion location at the time of advancement surgery. Measurements before and after medial rectus advancement were compared. Success was defined as alignment within 10Δ of orthotropia. The dose effect of medial rectus advancement was determined by nonlinear regression. Results A total of 20 patients were included. The mean age (± standard deviation) at time of surgery was 19 ± 19 years (range, 1.1–65.4). The mean preoperative exotropia was 28Δ ± 16Δ (range, 12Δ–60Δ). Medial rectus slippage of 2.5 ± 1.7 mm (range, 1.0–5.0 mm) was found in 14 patients (36%) who had previously undergone medial rectus recession. Surgery corrected about 4Δ of exotropia per mm total medial rectus advancement. Although 95% of patients were aligned successfully immediately after surgery, averaging 2Δ ± 4Δ esotropia, there was significant late exodrift, averaging 17Δ at final follow-up. At final follow-up, 1.6 ± 1.8 (range, 0.10–6.2) years after surgery, 50% of patients maintained alignment within 10Δ of orthotropia (mean, 3Δ ± 4Δ exotropia); the rest experienced recurrent exotropia of 25Δ ± 8Δ. Conclusions Medial rectus slippage is common in consecutive exotropia. Medial rectus advancement effectively treated consecutive exotropia, whether or not there was muscle slippage. It is however, associated with late exodrift; hence patients should be warned about potential for further XT recurrence.

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Section: Discussionsupporting

confidence: 65%

“…In a similar study by Cho and Ryu, 5 slipped medial rectus muscle was found in 22% of patients and was associated with limited adduction. Advancing the medial rectus muscle has reportedly improved the adduction deficits.…”

Section: Discussionmentioning

confidence: 59%

Consecutive exotropia: why does it happen, and can medial rectus advancement correct it?

Leon

Demer

2014

Journal of American Association for Pediatric Ophthalmology and

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“…Yoonae [14] and Ohtsuki [15] reported the successful recovery of consecutive exotropia by advancement of a single muscle. Ludwig [4] and Tinely [16] each reported successful postoperative results for a case of consecutive exotropia caused by a stretched scar, but the associated periods of observation were relatively short (11.4 and 4 months, respectively).…”

Section: Discussionmentioning

confidence: 99%

Characteristics and surgical outcomes of consecutive exotropia of different etiologies

et al. 2015

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“…According to Donaldson [9] a suitable ocular alignment immediately after surgery for consecutive exotropia is a small-angle esotropia of 5 to 10 PD as an exotropic drift occurs after consecutive exotropia surgery, usually within the first 6 weeks. The problem of development of a late exodrift after surgery has been reported by many authors [10]- [12]. Kolling G. H. and Schmidt-Bacher A.…”

Section: Discussionmentioning

confidence: 90%

“…[13] have noticed the development of an exodrift after three months of follow up, the mean value was-6 degrees, the dose-effect relation was reduced to 1.4 degrees/mm from 2 degrees/mm operative amount. Yoonae A Cho et al [12] concluded that the corrective value of Medial rectus advancement is 3 PD per 1 mm; Marcon G.B et al [11] results were a little bit different, the mean dose-effect being 5 PD at first day after surgery and 4 PD at 6 month. Regarding the choice of surgical technique a lot of authors prefer bilateral lateral rectus recession to all other methods [5] [14] [15].…”

Section: Discussionmentioning

confidence: 99%

Consecutive Exotropia after Convergent Strabismus Surgery—Surgical Treatment

Paduca¹

2016

OJOph

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Purpose: In this study the results of consecutive exotropia surgical treatment by using different surgical technics are presented. Methods: This study included 34 patients, aged 21 to 47 years (mean 27.9), who underwent medial rectus muscle advancement alone or in combination with medial rectus resection and/or lateral rectus recession. The mean interval between original surgery and surgery for consecutive exotropia was 8.5 years (range: 5.5 years to 14 years). Most of patients had 2 and more prior surgeries (73.5%) sold by an adduction deficit (47.06%). Results: The overall mean preoperative exodeviation was 35.12 ± 10.13 PD. Satisfactory alignment (within 10 PD of orthophoria) was achieved in 20 patients (58.8%) at 10 days after surgery and 24 patients (70.5%) at final 6-month follow-up. The most common surgical procedures were unilateral MR advancement and LR recession-47%. Conclusion: Medial rectus advancement is an effective method of surgical treatment, especially in cases with adduction limitation, but the risk of the eyelid fissure narrowing in cases of MRM advancement more than 5 mm associated with resection is present. In our opinion for reducing this risk in cases of XT with big angle of deviation, performing a smaller amount of advancement associated with recession of LRM can prevent the development of a such complication.

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The advancement of the medial rectus muscle for consecutive exotropia

Cited by 29 publications

References 25 publications

Consecutive exotropia: why does it happen, and can medial rectus advancement correct it?

Consecutive exotropia: why does it happen, and can medial rectus advancement correct it?

Characteristics and surgical outcomes of consecutive exotropia of different etiologies

Consecutive Exotropia after Convergent Strabismus Surgery—Surgical Treatment

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