Skip to main content

Advertisement

SpringerLink
Log in

Surgical outcomes related to degree of unilateral lateral rectus muscle recession in intermittent exotropia of 20 prism diopters

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

We compared the surgical results of different degrees of unilateral lateral rectus muscle recession (ULR) and investigated the surgical outcomes and factors related to recurrence of intermittent exotropia of 20 prism diopters (PD).

Study design

Retrospective study.

Methods

The study comprised 163 patients with intermittent exotropia of 20 PD who underwent ULR between January 2010 and May 2015 and at least 2 years of follow-up after the initial surgery. The patients were divided into 3 groups according to the extent of ULR (8.0, 8.5, or 9.0 mm), and the surgical results were compared. We investigated the surgical outcomes and factors related to recurrence.

Results

The mean postoperative follow-up period was 3.89 ± 1.82 years. The rate of recurrence within 2 years differed clinically (8.0 mm: 25.7%; 8.5 mm: 19.0%; 9.0 mm: 8.6%). However, other factors did not significantly differ among the groups. The comparison of the recurrence and the nonrecurrence groups showed that the age at the time of surgery varied significantly (recurring: 6.5 years, nonrecurring: 8 years; P = 0.012). A younger age at the time of surgery and a ULR of 8.0 mm were significant risk factors for the recurrence of ULR in intermittent exotropia of 20 PD.

Conclusion

We suggest that a surgical dose of 9.0 mm ULR is preferable to 8.0 mm ULR for intermittent exotropia of 20 PD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. McKean-Cowdin R, Cotter SA, Tarczy-Hornoch K, Wen G, Kim J, Borchert M, Multi-Ethnic Pediatric Eye Disease Study Group, et al. Prevalence of amblyopia or strabismus in Asian and non-Hispanic white preschool children: Multi-Ethnic Pediatric Eye Disease Study. Ophthalmology. 2013;120:2117–244.

    Article  PubMed  Google Scholar 

  2. Kushner BJ. Selective surgery for intermittent exotropia based on distance/near differences. Arch Ophthalmol. 1998;116:324–8.

    Article  CAS  PubMed  Google Scholar 

  3. Burian HM, Spivey BE. The surgical management of exodeviations. Am J Ophthalmol. 1965;59:603–20.

    Article  CAS  PubMed  Google Scholar 

  4. Dadeya S. Long-term results of unilateral lateral rectus recession in intermittent exotropia. J Pediatr Ophthalmol Strabismus. 2003;40:283–7.

    Article  PubMed  Google Scholar 

  5. Wang L, Nelson LB. Outcome study of unilateral rectus recession for small to moderate angle intermittent exotropia in children. J Pediatr Ophtalmol Strabismus. 2010;47:242–7.

    Article  Google Scholar 

  6. Menon V, Singla MA, Saxena R, Phulijele S. Comparative study of unilateral and bilateral surgery in moderate exotropia. J Pediatr Ophthalmol Strabismus. 2010;47:288–91.

    Article  PubMed  Google Scholar 

  7. Kim HJ, Kim D, Choi DG. Long-term outcomes of unilateral lateral rectus recession versus recess-resect for intermittent exotropia of 20–25 prism diopters. BMC Ophthalmol. 2014;14:46.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Spierer A, Ben-Simon GJ. Unilateral and bilateral lateral rectus recession in exotropia. Opthalmic Surg Lasers Imaging. 2005;36:114–7.

    Article  Google Scholar 

  9. Lyu IJ, Park K, Oh SY. Long-term surgical outcomes and factors for recurrence after unilateral lateral rectus muscle recession. Br J Ophthalmol. 2016;100:1433–6.

    Article  PubMed  Google Scholar 

  10. Kim H, Yang HK, Hwang JM. Comparison of long-term surgical outcomes between unilateral recession and unilateral recession-resection in small-angle exotropia. Am J Ophthalmol. 2016;166:141–8.

    Article  PubMed  Google Scholar 

  11. Deutsch JA, Nelson LB, Sheppard RW, Burke MJ. Unilateral lateral rectus recession for the treatment of exotropia. Ann Ophthalmol. 1992;24:111–3.

    CAS  PubMed  Google Scholar 

  12. Nelson LB, Bacal DA, Burke MJ. An alternative approach to the surgical management of exotropia: the unilateral lateral rectus recession. J Pediatr Ophthalmol Strabismus. 1992;29:357–60.

    CAS  PubMed  Google Scholar 

  13. Lim SH, Hong JS, Kim MM. Prognostic factors for recurrence with unilateral recess-resect procedure in patients with intermittent exotropia. Eye. 2011;25:449–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Lim SH, Hwang BS, Kim MM. Prognostic factors for recurrence after bilateral rectus recession procedure in patients with intermittent exotropia. Eye. 2012;26:846–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Gezer A, Sezen F, Nasri N, Gozum N. Factors influencing the outcome of strabismus surgery in patients with exotropia. J AAPOS. 2004;8:56–60.

    Article  PubMed  Google Scholar 

  16. Chia A, Seenyen L, Long QB. Surgical experiences with two-muscle surgery for the treatment of intermittent exotropia. J AAPOS. 2006;10:206–11.

    Article  PubMed  Google Scholar 

  17. Nusz KJ, Mohney BG, Diehl NN. The course of intermittent exotropia in a population-based cohort. Ophthalmology. 2006;113:1154–8.

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea

    Shin Yeop Oh

  2. Department of Ophthalmology, Pusan National University Hospital, Pusan, South Korea

    Hee Young Choi

  3. Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea

    Ju-Yeun Lee

  4. Department of Ophthalmology Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 06351, South Korea

    Sei Yeul Oh

Authors
  1. Shin Yeop Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hee Young Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ju-Yeun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sei Yeul Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SYO and SYO (corresponding author) designed the study. HYC and SYO conducted the study. SYO collected the data. J-YL and SYO managed the study and analyzed and interpreted the data. HYC and J-YL revised the manuscript critically for important intellectual content. SYO drafted and revised the manuscript. SYO (corresponding author) approved the final version of the manuscript.

Corresponding author

Correspondence to Sei Yeul Oh.

Ethics declarations

Conflicts of interest

Shin. Y. Oh, None; H. Y. Choi, None; J.Y. Lee, None; Sei. Y. Oh, None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding author: Sei Yeul Oh

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oh, S.Y., Choi, H.Y., Lee, JY. et al. Surgical outcomes related to degree of unilateral lateral rectus muscle recession in intermittent exotropia of 20 prism diopters. Jpn J Ophthalmol 64, 621–627 (2020). https://doi.org/10.1007/s10384-020-00771-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-020-00771-y

Keywords

Search

Navigation