Hyuna Kim1, Hee Kyung Yang1, Jeong-Min Hwang2. 1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. 2. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: hjm@snu.ac.kr.
Abstract
PURPOSE: To compare the surgical outcomes of unilateral lateral rectus recession-medial rectus resection (RR) and unilateral lateral rectus recession (ULR) for intermittent exotropia of ≤20 prism diopters (PD). DESIGN: Retrospective, nonrandomized clinical study. METHODS: A total of 130 children with intermittent exotropia of ≤20 PD who underwent unilateral RR or ULR of 10 mm were included. Patients were observed for at least 2 years. Success rates, cumulative probabilities of success, and factors related to recurrence and overcorrection were evaluated. RESULTS: The mean follow-up duration after surgery was 3.1 ± 1.0 years in the RR group and 3.6 ± 1.6 years in the ULR group. In the RR group, 38 of 61 patients (62%) had ocular alignment within 10 PD of exophoria/tropia and 5 PD of esophoria/tropia; 18 patients (30%) had recurrence, and 5 (8%) had overcorrection. In the ULR group, 26 of 69 patients (38%) had successful alignment, 41 patients (59%) had recurrence, and 2 patients (3%) were overcorrected. At 6 months after surgery, the success rate was significantly higher in the ULR group (RR 61%; ULR 78%, P = .039), but it became comparable after 2 years (RR 60%; ULR 52%, P = .370). At the final examination after a mean duration of 3 years, the recurrence rates were lower in the RR group (30% vs 59%, P = .001), and the overcorrection rates were comparable (8% vs 3%, P = .252). CONCLUSION: Unilateral RR resulted in more successful alignment and lower recurrence compared to ULR for the treatment of small-angle intermittent exotropia of ≤20 PD.
PURPOSE: To compare the surgical outcomes of unilateral lateral rectus recession-medial rectus resection (RR) and unilateral lateral rectus recession (ULR) for intermittent exotropia of ≤20 prism diopters (PD). DESIGN: Retrospective, nonrandomized clinical study. METHODS: A total of 130 children with intermittent exotropia of ≤20 PD who underwent unilateral RR or ULR of 10 mm were included. Patients were observed for at least 2 years. Success rates, cumulative probabilities of success, and factors related to recurrence and overcorrection were evaluated. RESULTS: The mean follow-up duration after surgery was 3.1 ± 1.0 years in the RR group and 3.6 ± 1.6 years in the ULR group. In the RR group, 38 of 61 patients (62%) had ocular alignment within 10 PD of exophoria/tropia and 5 PD of esophoria/tropia; 18 patients (30%) had recurrence, and 5 (8%) had overcorrection. In the ULR group, 26 of 69 patients (38%) had successful alignment, 41 patients (59%) had recurrence, and 2 patients (3%) were overcorrected. At 6 months after surgery, the success rate was significantly higher in the ULR group (RR 61%; ULR 78%, P = .039), but it became comparable after 2 years (RR 60%; ULR 52%, P = .370). At the final examination after a mean duration of 3 years, the recurrence rates were lower in the RR group (30% vs 59%, P = .001), and the overcorrection rates were comparable (8% vs 3%, P = .252). CONCLUSION: Unilateral RR resulted in more successful alignment and lower recurrence compared to ULR for the treatment of small-angle intermittent exotropia of ≤20 PD.