Abstract
Purpose: :
To report the median term outcome of the results between bilateral recession of the lateral recti (BLR) and monocular recess-resect procedure (RR) for the correction of exotropia of patients with a dominant fixating eye.
Methods: :
The medical records of 70 patients with exotropia who underwent surgery for exotropia from January 2002 to April 2008 and followed up for more than 6 months were reviewed retrospectively. The inclusion criteria were: basic type exotropia or and pseudo-divergence excess with or without normal stereopsis, with an invariably fixating eye. These patients underwent BLR or unilateral RR procedures on the nondominant eye; surgical outcomes were compared. An outcome was considered satisfactory if there was between 10 prism diopters of exophoria/tropia and 10 prism diopters of esophoria/tropia at 6 months after surgery.
Results: :
In the BLR group, success was obtained in 57.1% of the patients (20 of the 35 patients). There was no case of overcorrection in the BLR group. In the RR group, 27 of the 35 patients (77.1%) had a satisfactory outcome; 3 patients (8.6%) were overcorrected. All overcorrected patients in the RR group had poor stereoacuity. The surgical success was significantly higher in the RR group than in the BLR group (P <0.01, Mann-Whitney U test).
Conclusions: :
For the correction of exotropia of patients with a dominant fixating eye the unilateral RR procedure seems to be better than BLR recession surgery. When no dominant eye is shown the two procedures can be considered to be equally effective. But, the overcorrection rate was higher in the unilateral RR group.
Keywords: strabismus: treatment • esotropia and exotropia • strabismus