Abstract
Purpose :
To compare the long-term surgical outcomes between unilateral lateral rectus recession-medial rectus resection (RR) and lateral rectus recession-medial rectus plication (RP) in children with intermittent exotropia.
Methods :
Children who underwent RR or RP for intermittent exotropia between January 2008 and July 2016, with a minimum follow-up period of 2 years were included. Surgical outcomes were classified based on the postoperative angle of deviation at year 2 as follows: success (esodeviation ≤ 5 prism diopters [PD] to exodeviation ≤ 10 PD), and failure (overcorrection [esodeviation > 5 PD] and undercorrection or recurrence
[exodeviation > 10 PD]). Postoperative angle of deviations at 1 week, 1 month, 6 months, 1 year, and 2 years, and at the final follow-up were compared.
Results :
Of the 186 patients in the study, 114 underwent RR and 72 underwent RP. The angle of exodeviation steadily increased over time in both groups after surgery. The durations of exodrift was longer in the RP group than in the RR group. The surgical success at postoperative year 2 was 55.3% in the RR group and 27.8% in the RP group (P < 0.001). Clinical factors including sex, age, refractive errors, preoperative angle of deviation, types of exotropia, and stereopsis were not significantly associated with recurrence. However, the amount of overcorrection was associated with successful outcomes. In patients with a successful outcome, the mean distant esodeviation at postoperative week 1 was 11.2 PD in the RR group and 10.2 PD in the RP group.
Conclusions :
Patients with a successful outcome at 2 years had greater esodeviation at postoperative week 1 than those with a failed outcome. Establishing esodeviation more than 10 PD at postoperative week 1 in both RR and RP group is important for favorable surgical outcomes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.