Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 5;17(1):117.
doi: 10.1186/s12886-017-0512-5.

Comparison of outcomes of unilateral recession-resection as primary surgery and reoperation for intermittent Exotropia

Young Bok Lee  1 , Dong Gyu Choi  2
Affiliations

Comparison of outcomes of unilateral recession-resection as primary surgery and reoperation for intermittent Exotropia

Young Bok Lee et al. BMC Ophthalmol. .

Abstract

Background: The aim of this study was to compare the primary surgery and reoperation outcomes of unilateral lateral rectus recession and medial rectus resection (R&R) for intermittent exotropia.

Methods: We retrospectively reviewed the medical records of 80 patients, all of whom had undergone unilateral R&R for intermittent exotropia as a primary surgery or reoperation and been followed-up on postoperatively for 6 months or more. The patients were divided into two groups: unilateral R&R as primary surgery (group A, 44 patients) and unilateral R&R as reoperation (group B, 36 patients). The outcome measures were postoperative angle of deviation, surgical success rate, and mean dose-effect ratio (PD/mm, corrected angle of deviation / sum of amount of recession of lateral rectus and of resection of medial rectus). Surgical success was defined as exo- or esodeviation within 8 PD.

Results: The mean postoperative follow-up duration was 49.91 ± 14.83 months in group A and 43.17 ± 26.91 months in group B (p = 0.160). The mean angles of deviation at postoperative 1 day were -5.18 PD (overcorrection) in group A and -5.28 PD in group B (p = 0.932). However, there was a significant difference in the mean angle of deviation between the two groups at each visit from postoperative 3 months to final follow-up (p < 0.05): in short, group A had become more exotropic than group B. And the surgical success rate was higher in group B than in group A at each visit from postoperative 12 months to final follow-up (47.7% in group A and 83.3% in group B at final follow-up) (p < 0.05). The mean dose-effect ratio at 6 months after surgery was 1.89 ± 0.58 PD/mm in group A and 2.26 ± 0.32 PD/mm in group B (p = 0.001).

Conclusions: Unilateral R&R as reoperation presented better results for the surgical treatment of recurrent exotropia, showing a smaller exodrift pattern and higher surgical success rates compared with R&R as a primary surgery. The mean effect per millimeter (the mean dose-effect ratio, PD/mm) of R&R as reoperation was significantly greater than that of R&R as primary surgery at postoperative 6 months. These results could serve as useful guidelines in the planning of surgical correction for primary and recurrent exotropia.

Keywords: Dose-effect ratio; Intermittent exotropia; Surgical success rate; Unilateral recession-resection.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This study was conducted according to the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board of the Hallym University Medical Center (2014–12-176).

Consent for publication

Not applicable.

Competing interests

Neither of the authors (Young Bok Lee or Dong Gyu Choi) has any potential conflicts of interest (i.e. no relevant financial interests, activities, relationships or affiliations).

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Pearson’s correlation analysis: correlation between amount of recess-resect (mm) and dose-effect ratio (PD/mm) in groups A and B
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Jenkins RH. Demographic geographic variations in the prevalence and management of exotropia. Am Orthop J. 1992;42:82–87.
    1. Ing MR, Pang SW. The racial distribution of strabismus. A statistical study. Hawaii Med J. 1974;33:22–23. - PubMed
    1. Lim HT, Park SH, Ahn H, Yu YS, Kim S, Lee M, et al. Preschool vision screening in Korea: results in the year of 2001. J Korean Ophthalmol Soc. 2003;44:2318–2327.
    1. Yu YS, Kim SM, Kwon JY, Kim BC, Oh S, Rho YB, et al. Preschool vision screening in Korea: preliminary study. J Korean Ophthalmol Soc. 1991;32:1092–1096.
    1. Burian HM, Spivey BE. The surgical management of exodeviations. Am J Ophthalmol. 1965;59:603–620. doi: 10.1016/0002-9394(65)93991-7. - DOI - PubMed

LinkOut - more resources