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Comparative Study
. 2019 Aug 19;14(8):e0221268.
doi: 10.1371/journal.pone.0221268. eCollection 2019.

Do the primary surgical options for basic-type exotropia cause differences in distance-near discrepancy of recurrent exotropia after surgery?

Kwan Hyuk Cho  1 , Jinsoo Kim  1 , Dong Gyu Choi  2 , Joo Yeon Lee  1
Affiliations
Comparative Study

Do the primary surgical options for basic-type exotropia cause differences in distance-near discrepancy of recurrent exotropia after surgery?

Kwan Hyuk Cho et al. PLoS One. .

Abstract

Purpose: Most ophthalmologists appear to have no distinct preference between unilateral recess-resect (R&R) and bilateral lateral rectus (BLR) recessions to treat basic-type exotropia. This study aimed to determine whether differences in distance-near discrepancy and resultant exotropia types of recurrent exotropia following surgery for primary basic-type exotropia exist between the two surgical options.

Methods: Ninety-three patients with recurrent exotropia following BLR recessions for basic-type exotropia (BLR group) and 95 following R&R for basic-type exotropia (R&R group) were included in this retrospective study. The exotropia types in recurrent exotropia were classified into three types according to distance-near discrepancy: basic, divergence-excess, and convergence-insufficiency. The BLR and R&R groups were compared.

Results: After surgery for basic-type exotropia, the type composition changed differently in each group (p < 0.001). The basic-type of primary exotropia was more often maintained in recurrent exotropia in the R&R group than in the BLR group. The incidence of postoperative convergence-insufficiency type exotropia in the BLR group was 28.0% and 8.4% in the R&R group (p = 0.001). Postoperative near stereopsis and fusion control grade of distance deviation did not differ between the two groups (p > 0.05).

Conclusions: Convergence-insufficiency type recurrent exotropia occurred more frequently after BLR recessions than after R&R for basic-type exotropia. The high rate of secondary convergence-insufficiency type exotropia after BLR recessions should be considered when clinicians select a surgical option to treat exotropia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Bar graph showing the prevalence of the postoperative XT type between the BLR and R&R groups.
The rate of postoperative CI-type XT in the BLR group (28.0%) was higher than that in the R&R group (8.4%) (p = 0.001). BLR = bilateral lateral rectus recession; R&R = unilateral rectus recession-resection; DE = divergence excess; CI = convergence insufficiency; XT = exotropia.
See this image and copyright information in PMC

References

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