September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Lateral Rectus Central Plication Versus Medial Rectus Recession in Age-Related Distance Esotropia
Author Affiliations & Notes
  • Kenneth W Wright
    Wright Foundation for Pediatric Ophthalmology and Strabismus, Los Angeles, California, United States
  • Giulia Corradetti
    Wright Foundation for Pediatric Ophthalmology and Strabismus, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Kenneth Wright, Titan Surgical - Wright Grooved Hook (P); Giulia Corradetti, None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2446. doi:
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    • Get Citation

      Kenneth W Wright, Giulia Corradetti; Lateral Rectus Central Plication Versus Medial Rectus Recession in Age-Related Distance Esotropia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2446.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Rectus central plication is a minimally invasive tightening procedure recently described by one of the authors (KW). We compare outcomes of lateral rectus central plication (LRCP) to standard medial rectus recession (MRR) in the treatment of age-related distance esotropia (ARDE).

Methods : A retrospective chart review of consecutive patients who underwent either LRCP or MRR surgery for ARDE between 2010 and 2015 was performed. Inclusion criteria: ≥ 40 years of age, LRCP or MRR surgery fixed suture technique, esotropia (ET) at least 10 prism diopters (PD) greater for distance than near and diplopia. Primary outcome was postoperative single binocular vision (no diplopia). Secondary outcome was postoperative deviation < 5PD.

Results : Twenty-five patients met inclusion criteria (12 LRCP; 13 MRR). Primary outcome of no diplopia was significantly better for the LRCP group (84%) vs the MRR group (69.3%). Secondary outcome of a deviation < 5 PD was the same as the primary outcome (84% LRCP and 69.3% MRR; p-value=0.0032). In the LRCP group there was 1 over-correction which resolved after cutting one plication suture 2 weeks post-operative. The MRR group had 4 under-corrections. Statistical analysis was performed for all data.

Conclusions :
Both procedures resulted in reduction of diplopia and distance-near disparity, however, the LRPC group had a significantly better outcome. Virtually all LRCP patients were diplopia free as the one patient with a consecutive XT improved after in-office lysis of one of the plication sutures. The LRCP is advantageous as it is minimal invasive, reversible, and vessel sparing.
In conclusion LRCP is a minimal invasive effective alternative to MRR in the surgical treatment of ARDE.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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