Lihua Wang1, Leonard B Nelson. 1. Department of Pediatric Ophthalmology and Strabismus, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA.
Abstract
PURPOSE: To report an outcome study of 100 consecutive children with intermittent exotropia treated by unilateral rectus recession for small to moderate angle exodeviation with a minimum follow-up of 6 months. METHODS: The records of patients with intermittent exotropia younger than 15 years who underwent 7-to-10-mm unilateral lateral rectus recession for exodeviation measuring 15 to 35 prism diopters (PD) from January 2000 to July 2008 were retrospectively reviewed. The surgery were performed accordingly to the amount of distance deviation. A successful alignment was defined as an exodeviation of 5 PD or less and absence of any esotropia in primary and lateral gaze while viewing distant or near targets. RESULTS: Successful alignment was achieved in 99%, 88%, and 76% of patients at early postoperative, 6-month, and final follow-up, respectively. One overcorrected patient had an esodeviation of 20 PD at 6 months. The results of the final follow-up did not depend on age or refraction at the level of 0.05, whereas the amount of initial exodeviation was found to be significantly correlated with success at the final examination (P = .041). There was a positive significant relationship between results at 6 months and final follow-up (P = .000, r = 0.449). Eleven of the 13 patients who had a second surgery and were observed more than 6 months had successful alignment. Eighty-nine percent of the patients achieved a successful outcome with the combined primary and secondary surgery at the final follow-up. CONCLUSION: Unilateral lateral rectus recession is a safe and effective treatment for small to moderate angle intermittent exotropia in children.
PURPOSE: To report an outcome study of 100 consecutive children with intermittent exotropia treated by unilateral rectus recession for small to moderate angle exodeviation with a minimum follow-up of 6 months. METHODS: The records of patients with intermittent exotropia younger than 15 years who underwent 7-to-10-mm unilateral lateral rectus recession for exodeviation measuring 15 to 35 prism diopters (PD) from January 2000 to July 2008 were retrospectively reviewed. The surgery were performed accordingly to the amount of distance deviation. A successful alignment was defined as an exodeviation of 5 PD or less and absence of any esotropia in primary and lateral gaze while viewing distant or near targets. RESULTS: Successful alignment was achieved in 99%, 88%, and 76% of patients at early postoperative, 6-month, and final follow-up, respectively. One overcorrected patient had an esodeviation of 20 PD at 6 months. The results of the final follow-up did not depend on age or refraction at the level of 0.05, whereas the amount of initial exodeviation was found to be significantly correlated with success at the final examination (P = .041). There was a positive significant relationship between results at 6 months and final follow-up (P = .000, r = 0.449). Eleven of the 13 patients who had a second surgery and were observed more than 6 months had successful alignment. Eighty-nine percent of the patients achieved a successful outcome with the combined primary and secondary surgery at the final follow-up. CONCLUSION: Unilateral lateral rectus recession is a safe and effective treatment for small to moderate angle intermittent exotropia in children.