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Kang Hoon Lee, Sung Mo Kang; Predictive Factors For Successful Outcome And Recurrence With Bilateral Lateral Rectus Muscle Recession In Patients With Basic Type Intermittent Exotropia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1770.
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To evaluate the predictive factors, particularly age, gender, refractive error, near and distant deviation angle, presence of suppression at the time of surgery, for successful outcome and recurrence after bilateral lateral rectus muscle recession in patients with basic type intermittent exotropia.
Medical records of 100 subjects who received bilateral lateral rectus muscle recession procedures with more than 12 months of follow-up were reviewed. The patients' surgical outcomes with a deviation of less than 8 prism diopters (PD) of exotropia or esotropia were defined as a success. Outcomes with more than 10 PD of exotropia were designated as recurrences, and those with esotropia of more than 10 PD after 3 months of operation were noted as overcorrection. The prognostic factors for recurrence were analyzed by the multivariate logistic regression test.
Of the 100 subjects, 85 had successful surgical outcomes and 15 had recurrences, whereas overcorrection was not found. Mean age at operation was 8.3 ± 6.3 years, mean preoperative distant X(T) size was 32.9 ± 6.0 PD, and mean follow-up period was 15.5 ± 17.9 months. On the basis of the survival analysis in which survival represented time of recurrence, the mean duration was 24.2 ± 1.5 months. Age at onset, age at surgery, and immediate postoperative alignment proved to be significant factors influencing a favorable outcome by multivariate logistic regression analysis (P<0.05). However, gender, refractive error and preoperative deviation size were not significantly predictive of success or recurrence rate (P>0.05).
In bilateral lateral rectus muscle recession procedures, increasing patient age at the time of surgery was associated with lower recurrence rates. Recurrence rates also increased with the immediate postoperative angle and with the postoperative angle of deviation at 1, 3, 6, and 12 months.
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